Does elevated neutrophil-lymphocyte-ratio and platelet-lymphocyte-ratio indicate Helicobacter pylori infection among dyspeptic patients ? A cross-sectonal analytical study from Chitwan Medical College Teaching Hospital, Nepal

Abstract

INTRODUCTION

Acid peptic disease (APD) is a common gastrointestinal condition with a higher prevalence in populations of lower socioeconomic status. Various factors, including infections and specific medications, contribute to its development. This study investigated the relationship between simple, cost-effective inflammatory biomarkers - the Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) and Helicobacter pylori (HP) infection.

MATERIAL AND METHODS

Out of the 334 study participants with dyspeptic symptoms enrolled in this study, 167 were confirmed HP-positive through hematoxylin and eosin (H&E) staining of biopsy specimens obtained following upper gastrointestinal endoscopy. An equal number of age- and sex-matched HP-negative patients with dyspeptic symptoms were enrolled as controls. Venous blood samples were obtained and analyzed for complete blood count, and NLR and PLR were calculated post endoscopy.

RESULTS

We observed HP infection in 60% of female participants presenting with dyspeptic symptoms.  A significant correlation was observed between dyspeptic symptoms categorized a postprandial epigastric discomfort, burning epigastric pain, and bloating with HP infection. Both NLR (<0.001) and PLR (<0.05) demonstrated statistically significant associations with HP infection status. Receiver operating characteristic (ROC) analysis suggested NLR to be a superior predictor of HP positivity compared to PLR.

CONCLUSION

This findings of the present study suggests NLR and PLR could serve as predictive inflammatory markers for HP infection in patients with dyspeptic symptoms. These findings may serve healthcare providers in resource-limited settings potentially helping in referral for specialist care and endoscopic evaluation.  Specialist physicians and tertiary health centers could use these ratios in monitoring HP eradication therapy.