A Case-control Study Of The Relationship Between Helicobacter Pylori Infection And Duodenal Brunner’s Gland Hyperplasia

Objective : To investigate the relationship between duodenal Brunner’s gland hyperplasia and Helicobacter pylori(Hp) infection.Methods: A total of 96 patients with duodenal Brunner’s gland hyperplasia diagnosed by pathological examination from October 2005 to December 2013 at People’s Hospital of Xinjiang Uygur Autonomous Region were enrolled in this study. A total of 270 cases without duodenal Brunner’s gland hyperplasia were served as controls. Hp infection was detected by 14C-urea breath test and Warthin- Starry argentation. Eight-two cases with confirmed false-negative 14C-UBT and 813 controls with true-positive 14C-UBT at the People’s Hospital of Xinjiang Uygur Autonomous Region from Jan. 2014 to Aug. 2014 were enrolled. Patients in both groups were diagnosed as positive for Hp infection by Warthin-Starry silver staining combined with Hp stool antigen test. Univariate and multivariate analysis were performed to screen the factors related with false-negative 14C-UBT. Χ2-test was performed to the relationship between duodenal Brunner’s gland hyperplasia and Hp infection.Results: In univariate analysis, 5 variables were significantly different between case group and control group(P<0.05), and were taken into the multivariate analysis.Logistic stepwise regression analysis revealed that bile reflux(OR=3.961, P<0.001), post subtotal gastrectomy(OR=9.734, P<0.001), type Ⅱ Hp infection(OR=1.892, P=0.012) and upper gastrointestinal bleeding(OR=4.979, P<0.001) were the independent risk factors for false-negative 14C-UBT.In the case group, 75 cases were Hp infection, exposure proportion was 3.57(75/21). In the control group 110 cases were Hp infection, exposure proportion was 1.45(160/110). The difference between the two groups was statistically significant(?2=10.968, P=0.001, OR=2.46, 95%CI: 1.444~4.191). Conclusion:1.Bile reflux, upper gastrointestinal bleeding, post subtotal gastrectomy and type Ⅱ Hp infection might be the influential factors for false-negative 14C-UBT. Combined tests for Hp infection should be suggested in patients with negative 14C-UBT who had undergone subtotal gastrectomy or complicated with bile reflux or upper gastrointestinal bleeding2.Hp infection may be related to the genesis of duodenal Brunner’s gland hyperplasia.