Abstract: Objective To statistically analyze the distribution and clinical significance of different antibody types of Helicobacter pylori（Hp） infection in various stages of gastric mucosa lesions （non-atrophic gastritis， atrophic gastritis， gastric ulcer， intraepithelial neoplasia，and gastric cancer）. Methods 2 081 inpatients admitted to the Third People's Hospital of Hubei Province Affiliated to Jianghan University from 2019 to 2021 were enrolled. The C13 breath test， serological antibody test， gastroscopy， and pathological examination were performed simultaneously. According to the results of gastroscopy and pathological examination，the patients were divided into five groups：non-atrophic gastritis （917 cases），atrophic gastritis （636 cases），gastric ulcer （406 cases），intraepithelial neoplasia（89 cases），and gastric cancer（33 cases）. The relationship between Hp infection with different toxin types and patients' age，gastroscopy，and pathological diagnosis was statistically analyzed. ResultsThe infection rate of Hp in each group from high to low was gastric cancer group，intraepithelial neoplasia group，atrophic gastritis group，gastric ulcer group，and non-atrophic gastritis group，and the difference was statistically significant （P < 0. 05）. A total of 653 cases of type I Hp and 324 cases of type II Hp were detected in 2 081 patients. The positive rate of type I Hp was higher than that of type II Hp in each group，and the difference was statistically significant（P < 0. 05）. There were significant differences in the positive rate of type I Hp and type II Hp among all groups（P < 0. 05）. There were significant differences in cytotoxin-associated protein A（CagA），vacuolar toxin （VacA），and urease（Ure）among all groups（P < 0. 05），and Ure antibody increased with age（≥ 50）. Among 653 patients with type I Hp positive，the CagA + VacA antibody （60. 0%） was the main antibody，which was higher than CagA antibody （36. 2%） and VacA antibody （3. 6%），and the differences were statistically significant （P < 0. 05）. Among 324 patients with type II Hp positive，the positive rate of UreB antibody（64. 8%） in each group was higher than that of UreA + UreB antibody（30. 5%）and UreA antibody （4. 6%），and the difference was statistically significant （P < 0. 05）. Conclusion Hp infection is closely related to gastric mucosal lesions. Type I Hp strain is the main pathogenic strain of gastric diseases，but type II Hp strain infection should not be ignored.

Key words: Helicobacter pylori, antibodies to Helicobacter pylori, disease of the stomach