Evaluation of Platelet-to-Lymphocyte Ratio and 13C-Urea Breath Test as Non-Invasive Markers for Helicobacter pylori Infection

Karwan Anwar Hassan ALJAF; Bahman Ibrahim Rahman; Shox Omed Saeed; Arivan Azad Fatah; Akam Ibrahim Aziz Abdula; Hevi Ali Hama

doi:10.59828/ijsrmst.v4i7.341

Authors

Karwan Anwar Hassan ALJAF Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq/ Department of Biology, College of Education, Garmian University, Kalar District, Sulaimaniyah, Kurdistan Region, Iraq. Author
Bahman Ibrahim Rahman Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq. Author
Shox Omed Saeed Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq Author
Arivan Azad Fatah Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq Author
Akam Ibrahim Aziz Abdula Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq. Author
Hevi Ali Hama Department of Medical Laboratory, National Institute for Technology, Sulaimani, Kurdistan region, Iraq. Author

DOI:

https://doi.org/10.59828/ijsrmst.v4i7.341

Keywords:

Helicobacter pylori (H. pylori), non-invasive, platelets-to-lymphocytes ratio (PLR), urea breath test (UBT)

Abstract

Background: Helicobacter pylori (H. pylori) is a widespread stomach pathogen known to cause chronic gastritis, peptic ulcers, and gastric cancer. Reliable diagnosis and measurement of infection severity are crucial for proper treatment.

Aim: This study aimed to analyze blood-based and inflammatory markers in patients tested for H. pylori and investigate the potential of the platelet-to-lymphocyte ratio (PLR) as a simple, non-invasive diagnostic tool.

Methods: We divided 110 patients into three groups based on test results: Group I (n = 27) tested negative in blood, stool, and urea breath test (UBT); Group II (n = 34) was positive only in UBT (C13 > 4%); and Group III (n = 49) tested positive in all three tests. We compared blood cell counts, including white blood cells (WBC), hematocrit (HCT), lymphocytes, platelets, and PLR. The diagnostic performance of PLR was evaluated using ROC curve analysis.

Results: WBC, HCT, and lymphocyte counts showed no significant differences between groups. However, platelet counts were notably higher in Group III than in Groups I and II (p < 0.05). UBT (C13%) values rose progressively from Group I to Group III, indicating increased bacterial activity. PLR was significantly higher in Group III compared to Group II (p < 0.05). ROC analysis confirmed PLR’s strong diagnostic ability, with an AUC of 97%, 95% sensitivity, 100% specificity, and an optimal cutoff value of 9.5.

Conclusion: PLR proved to be a highly accurate, affordable, and non-invasive marker for active H. pylori infection. UBT (C13%) levels also correlated with infection severity, supporting its use in detecting and measuring bacterial load. These findings suggest PLR could be a valuable tool in clinical practice.