Caspian Journal of Internal Medicine 2022; 13(2): 398-404 DOI: 10.22088/cjim.13.2. 398 Original Article © The Author(s) Publisher: Babol University of Medical Sciences Hassan Salmanroghani (MD) 1 Mohammad Hassan Rouzegari (MD) 2* Roham Salmanroghani (MD) 2 1. Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2.Department of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran * Correspondence: Mohammad Hassan Rouzegari, Department of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran E-mail: md.hassan66@yahoo.com Tel: 0098 21 6947985 Fax: 0098 21 8799840 Received: 20 Feb 2021 Revised: 11 April 2021 Accepted: 24 April 2021 Helicobacter Pylori infection among Iranian patients with normal upper gastrointestinal endoscopy Abstract Background: Helicobacter pylori infection can be a risk factor for non-cardia gastric cancer. In the present study, we aimed to assess the rate of Helicobacter pylori infection, its virulence factor and precancerous lesion among over 50 years old, dyspeptic patients with normal endoscopy. Methods: A total of 620 patients over 50 years of age with dyspepsia that referred to Shahid Sadoughi Hospital, Yazd, Iran from December 2018 to January 2019 were evaluated. One hundred fifty patients with normal appearance endoscopy were selected, and six gastric biopsy specimens were taken from each subject. Data were analyzed using chi-square and logistic regression tests. Results: A total of 150 patients with mean age of 65.8±11.9 years old participated in this study. Sixty-three (42%) patients were males. Thirty-four (22.6%) patients had precancerous lesions. Ninety (60%) patients had positive PCR results for H. pylori. H. pylori infection test was positive in 24 (70.6%) patients with precancerous lesion. Sixty-six (57%) patients without the precancerous lesions (116 cases) were positive for H. pylori. Conclusion: There was no a significant difference in the rate of H. pylori infection and its genotype distribution was between patients with and without the precancerous lesions. Keywords: Endoscopy, Helicobacter pylori, Gastric cancer, Dyspepsia Citation: Salmanroghani H, Rouzegari MH, Salmanroghani R. Helicobacter Pylori infection among Iranian patients with normal upper gastrointestinal endoscopy. Caspian J Intern Med 2022; 13(2): 398-404. H elicobacter pylori (H. pylori), or classically called Campylobacter pyloridis, is found in about 50% of peoples all around the world. H. pylori has been proposed to be causative in gastrointestinal disorders, such as gastritis, peptic ulcer, gastric cancer (GC) or mucosa-associated lymphoid-tissue lymphoma (1). Stomach cancer is the most common cancer in men and is the third cancer after breast and colorectal cancer among women in Iran (2). The International Agency for Research on Cancer (IARC) has classified H. pylori as the group 1 carcinogen since 1994 (3). The previous studies have revealed that the occurrence of gastric cancer has increased in populations with high prevalence of H. pylori infection. Prevalence of H. pylori infection is high among the Iranian population and the age of acquisition of infection in Iran is low (4). H. pylori virulent factors are important when combined with host and environmental factors (5). Researchers have reported that H. pylori infection, although is closely linked to the development of gastric cancer, does not increase all-cause mortality. (6). Significant variations in vacuolating activities are observed between the different strains of H. pylori. These variations are attributed to the polymorphisms of vacA gene that play a key role in vacuolating activity and is significantly linked to gastric adenocarcinoma. The vacA-d1 type gene is associated with neutrophil infiltration and gastric mucosal atrophy in both the antrum and the corpus.