HISTOPATHOLOGICAL AND BIOCHEMICAL CORRELATION OF HELICOBACTER PYLORI INFECTION IN CHRONIC GASTRITIS

Abstract

Background: Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and persistent gastric mucosal inflammation. Histopathological assessment provides direct evidence of mucosal injury, while the relationship between bacterial density and different histological changes helps characterize disease severity. Objective: To evaluate the histopathological and biochemical correlation of H. pylori infection in patients with chronic gastritis. Study Design & Setting: This was a descriptive analytical cross-sectional study conducted in the Department of Pathology Bahria University Health Sciences, Karachi from August 2025 to January 2026. Methodology: A total of 150 adult patients with chronic gastritis were included through consecutive sampling. Gastric biopsy specimens were processed and examined using hematoxylin and eosin and modified Giemsa staining. Histopathological changes, including chronic inflammation, neutrophilic activity, glandular atrophy, intestinal metaplasia, and H. pylori density, were graded according to the Updated Sydney System. Blood samples were also analyzed for selected biochemical parameters. Associations between H. pylori status and histopathological findings were assessed using appropriate statistical tests, while correlations were evaluated using correlation analysis. Results: H. pylori infection was identified in 78 (52.0%) patients. Among positive cases, mild, moderate, and severe bacterial density was observed in 39 (50.0%), 29 (37.2%), and 10 (12.8%), respectively. Chronic inflammation was significantly associated with H. pylori status (p=0.003), as was neutrophilic activity (p<0.001). Glandular atrophy and intestinal metaplasia were not significantly associated with infection (p=0.089 and p=0.126, respectively). H. pylori density showed significant positive correlations with chronic inflammation (r=0.521, p<0.001), neutrophilic activity (r=0.596, p<0.001), and glandular atrophy (r=0.228, p=0.045). Conclusion: H. pylori infection was common among patients with chronic gastritis and was significantly associated with inflammatory histopathological changes. Increasing bacterial density was correlated with greater chronic inflammation and neutrophilic activity.