Abstract: Objective To observe the relationship between Helicobacter pylori (H.pylori) infection with different toxin types and different gastric mucosa lesions, and to explain the clinical significance of antibody typing detection. Methods A total of 568 patients were enrolled who underwent antibody typing of H.pylori and gastroscopy and biopsy from January 2020 to December 2020, and they were grouped by H.pylori infection, age, H.pylori antibody typing, gastroscopic diagnosis and pathological diagnosis. The relationship between H.pylori infection with different toxin types and patients' age, gastroscopic diagnosis and pathological diagnosis was analyzed. Chi-square test was used for statistical analysis. Results The proportion of positive patients greater than or equal to 50 years old, male and H.pylori in chronic atrophic gastritis and intestinal metaplasia group and early gastric cancer group was significantly higher than that in the control group, with a statistical significance (P<0.05). In the chronic non-atrophic stomach group, the positive rates of H.pylori CagA and VacA antibodies in patients<50 years old were significantly higher than those in patients≥50 years old, with statistical significance (P<0.05). However, there was no significant difference in the typing of H.pylori antibody in the chronic atrophic gastritis and intestinal metaplasia group (P>0.05). There were statistically significant differences in H.pylori strain infection among patients with gastric mucosal lesions in the three groups (P<0.05). The infection proportions of high-virulence strain and low-virulence strain in chronic atrophic gastritis and intestinal metaplasia group and early gastric cancer group were higher than those in chronic non-atrophic gastritis group. Conclusion Chronic H.pylori infection is associated with chronic atrophic gastritis, intestinal metaplasia, early gastric cancer and other gastric mucosal lesions, while H.pylori high virulence strain infection is associated with atrophic gastritis, intestinal metaplasia, and early gastric cancer. Chronic atrophic gastritis, intestinal metaplasia, early gastric cancer and other gastric mucosal lesions in patients infected with H.pylori low virulence strain still account for a certain proportion. It remains to explore the reliability of the classification of H.pylori virulence antibody in predicting gastric mucosal lesions in patients and helping to make decisions on whether to eradicate H.pylori.

Key words: Helicobacter pylori antibody, gastritis, atrophic, intestinal metaplasia, early gastric cancer