Combined Assessment of Gastric Mucosal Damage Associated with Helicobacter Pylori Infection in Children by Virulence Factors and Pepsinogen

ObjectiveTo investigate the value of combining Helicobacter pylori (HP) virulence factor typing with pepsinogen (PG) in assessing HP infection-related gastric mucosal injury in children.MethodsA cross-sectional study enrolled children presenting with gastrointestinal symptoms at Wuxi Children's Hospital from August 2023 to December 2024. Based on gastroscopic pathology, participants were assigned to a mild injury group (n=66) or a moderate/severe injury group (n=51). Serum PG levels and HP virulence factor typing (type I/II) were examined to evaluate the diagnostic performance of combined testing for mucosal injury severity.ResultsThe moderate/severe injury group had higher serum PGI and PGII levels than the mild injury group (P<0.05), and type I HP infection predominated (85.7%). Receiver operating characteristic curve analysis showed the following diagnostic performance for moderate/severe gastric mucosal injury: type I HP plus PGI positivity yielded an area under the curve (AUC) of 0.781, specificity 62.1%, and sensitivity 82.4%; type I HP plus PGII positivity yielded an AUC of 0.742, specificity 90.9%, and sensitivity 47.1%; simultaneous positivity for type I HP, PGI, and PGII yielded an AUC of 0.775, specificity 60.6%, and sensitivity 82.4%.ConclusionsSerum PG levels and type I HP infection are closely associated with gastric mucosal injury severity. Their combined detection demonstrates good diagnostic performance for grading injury severity and provides a noninvasive strategy for clinical assessment of HP-related gastric mucosal damage in children.