Frecuencia y asociación entre helicobacter pylori, metaplasia, displasia y neoplasia gástricas en el Laboratorio H&E de la ciudad de Cuenca en el periodo julio 2020- diciembre 2021

Abstract

Background: Helicobacter pylori (H. pylori) can colonize the gastric mucosa and affects more than half of the world's population, with a higher prevalence in developing countries. The World Health Organization (WHO) recognizes it as a Type I carcinogen due to its association with gastric adenocarcinoma. High rates of infection and gastric neoplasms are recorded in our setting, although recent local studies are limited. Objectives: To determine the frequency and association of H. pylori infection, metaplasia, dysplasia, and gastric neoplasia in patients evaluated at the H&E laboratory in the city of Cuenca between July 2020 and December 2021. Methods: An analytical, observational, retrospective, cross-sectional study. A total of 653 histopathological reports were analyzed to evaluate the frequency and association between variables using analytical statistical analysis. Results: The prevalence of H. pylori was 62.6%. Intestinal metaplasia reached 45.9%, dysplasia 22%, and neoplasia 2.8%, with poorly differentiated adenocarcinoma and the intestinal subtype predominating. Metaplasia (χ2=143,3; p=0,001; OR adjusted=0,420; IC95%: 0,201–0,879) and dysplasia (χ2=38,1; p=0,001; OR crude=0,332; IC95%: 0,203–0,544) were more frequent in H. pylori-negative subjects. Glandular atrophy showed a positive gradient association with metaplasia (OR=4,1– 7,2) y dysplasia (OR=7,7–21,2). Neoplasia was not associated with H. pylori in the crude analysis (χ2=0,735; p=0,391), but an independent association emerged after adjustment (OR=202,4; IC95%: 2,71–15.129; p=0,016). Furthermore, incidentally, a considerable frequency (83.5%) of patients with data suggestive of autoimmune gastritis was found.