The Neutrophil/Lymphocyte Ratio in Helicobacter pylori Infected Patients:  A Comparative Therapeutic Study to Reduce Risk of Gastric Cancer

Dhifaf R. Reesn ¹, Majid S. Jabir ^2*

The study investigated Helicobacter pylori infection, its impact on inflammatory markers, and treatment efficacy, offering insights into diagnosis and management.

Abstract

Background: Helicobacter pylori (HP) infection is known to induce localized inflammation in the gastric region and trigger a systemic humoral immune response. Previous research in adults has shown a significant correlation between HP infection and changes in the neutrophil/lymphocyte ratio (NLR) as well as the mean levels of neutrophils and lymphocytes. Determining the optimal course of therapy for HP infection relies on results from antibiotic susceptibility testing. Methods: This study aimed to investigate the association between HP infection and immunological responses before and after two distinct treatment modalities. The study included individuals across different age groups and health conditions: children aged 12–16 years, pregnant women aged 19–35 years, individuals with chronic diseases (diabetes and hypertension) aged 45–75 years, youth patients aged 18–45 years, and healthy controls. A total of 240 patients scheduled to undergo gastroduodenoscopy were included, with 120 testing positive for HP and 120 testing negative. The average age of both HP-positive and HP-negative patients was 45.56±12.16 years. Results: The study found that the eradication rate for H. pylori infection was satisfactory using second-line therapies. Specifically, standard 5-week sequential therapy showed a higher effectiveness rate (100%) compared to standard triple therapy (4%), especially when the strains were susceptible to clarithromycin. There were no significant differences observed in the levels of NLR, neutrophils, and lymphocytes values between the two treatment modalities (p > 0.05). Conclusion: These findings suggest that standard 5-week sequential therapy may be more effective in eradicating HP infection compared to standard triple therapy, particularly in cases where the strains are susceptible to clarithromycin. However, the study emphasizes the importance of generating regional data on the success rates of various therapeutic approaches to establish effective treatment strategies for HP infection.

Keywords: Helicobacter pylori, Gastritis, Neutrophil-to-Lymphocyte Ratio (NLR), Antibiotic Resistance, Treatment Strategies

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