Comparison of clinical, serological and histological findings between non-ulcer dyspepsia patients with and without Helicobacter pylori infection

Background and Aims: The role of Helicobacter pylori (H. pylori) infection in non-ulcer dyspepsia (NUD) remains controversial. This study investigates the clinical, serological and histological differences between patients wi th H. pylori-positive and -negative NUD. Methods: One hundred and eighty consecutive patients with NUD were enrolled from January to December 1998. The severity of symptoms was evaluated by t he Tucci's scoring system. The histological changes of gastric mucosa were assessed according to the Updated Sydney System, and a fasting blood sample was obtained to test the serum gastrin and pepsinogen I levels. Results: The H. pylori-positive NUD patients were notably older than H. pyl ori-negative NUD patients (48.2 +/- 15.9 vs 39.8 +/- 15.7 years, P = 0.001) . There were no differences in other clinical factors between the two NUD g roups. The serum pepsinogen I levels were considerably higher in H. pylori- positive NUD patients than in H. pylori-negative NUD patients (78.9 +/- 42. 2 vs 61.5 +/- 43.3 ng/mL, P < 0.01). However, no significant differences in serum gastrin levels were discovered between the two groups. The antrum hi stological scores for chronic inflammation, acute inflammation, gland atrop hy and lymphoid follicles were higher in H. pylori-positive NUD patients th an in H. pylori-negative NUD patients (2.09 vs 1.01, P < 0.001; 1.22 vs 0.3 6, P < 0.001; 0.76 vs 0.36, P < 0.01; 0.33 vs 0.13, P < 0.01, respectively) . Conclusions: The present study discovered marked differences in age, serum pepsinogen I levels, histological grades of acute inflammation, chronic inf lammation, gland atrophy and lymphoid tissue formation between H. pylori-po sitive and H. pylori-negative NUD patients. Further investigation of the cl inical prognosis of the two groups of patients is necessary. (C) 2001 Black well Science Asia Pty Ltd.