Among gastric cancers (GC), Intestinal type adenocarcinomas often preceded by prolonged precancerous lesions cause by H. pylori infections. In Asia, Iran has the fourth ranking of gastric cancer. There is a lower incidence rate of gastric cancer in Yazd, central Iran, compared to Ardebil, northern Iran, but the reason is not clear. In this study, we want to assess the prevalence of H. pylori infections and its subtypes and precancerous lesions in individuals with normal endoscopies and aim to understand the causes of this lower incidence GC rate in Yazd.

A total of 150 patients in Yazd, affected with dyspepsia, 50 years old or above and with normal endoscopy results, participated in the study. Seven gastric biopsy specimens were taken (five for histopathologic examination and classification, one for genotyping of H. pylori (PCR amplification) and another one for rapid urease test).

Among the precancerous lesion samples (n=34), there were 16 (48%) positive results for H. pylori and 18 (52%) negative ones using the Giemsa stain, and 15 (44%) positive results for H. pylori and 19 (56%) negative ones using the rapid urease test. Among normal pathology group (n=116), 60 (52%) tested positive for H. pylori and 56 (48%) tested negative, using each of these tests. Normal pathology and precancerous lesion group were not significantly different in prevalence of H. pylori genotype varieties, in any subtype (in both chi-square and logistic regression model tests).

In our study, the prevalence of H. pylori and precancerous lesions in Yazd was lower than Ardebil. The statistics analysis was not significant between precancerous lesions and normal pathology group, although the odds ratio for virulent genotypes of H. pylori was in favor of precancerous lesions [except M1]; and for not virulent genotypes of H. pylori, was in favor of normal pathology group.