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Close observation of gastric mucosal pattern by standard endoscopy can predict Helicobacter pylori infection status.

Abstract：

BACKGROUND AND AIM:Common endoscopic findings in stomachs with Helicobacter pylori infections include antral nodularity, thickened gastric folds, and visible submucosal vessels. These findings are suggestive but not diagnostic of H. pylori infection. Magnifying endoscopy can reveal more precisely the abnormal mucosal patterns in an H. pylori-infected stomach; however, it requires more training, expertise, and time. We aimed to establish a new classification for predicting H. pylori-infected stomachs by non-magnifying standard endoscopy alone. METHODS:A total of 617 participants who underwent gastroscopy were prospectively enrolled from August 2011 to January 2012. We performed a careful close-up examination of the corpus at the greater curvature maintaining a distance ≤ 10 mm between the endoscope tip and the mucosal surface. We classified gastric mucosal patterns into four categories: normal regular arrangement of collecting venules (numerous minute red dots), mosaic-like appearance (type A; swollen areae gastricae or snakeskin appearance), diffuse homogenous redness (type B), and untypical pattern (type C; irregular redness with groove) to predict H. pylori infection status. RESULTS:The frequencies of H. pylori infection in patients with a normal regular arrangement of collecting venules pattern and types A, B, and C patterns were 9.4%, 87.7%, 98.1%, and 90.9%, respectively. The sensitivity, specificity, and positive and negative predictive values of all abnormal patterns for prediction of H. pylori infection were 93.3%, 89.1%, 92.3%, and 90.6%, respectively. The overall accuracy was 91.6%. CONCLUSIONS:Careful close-up observation of the gastric mucosal pattern with standard endoscopy can predict H. pylori infection status.

journal_name

J Gastroenterol Hepatol

journal_title

Journal of gastroenterology and hepatology

authors

Cho JH,Chang YW,Jang JY,Shim JJ,Lee CK,Dong SH,Kim HJ,Kim BH,Lee TH,Cho JY

doi

10.1111/jgh.12046

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

279-84

issue

eissn

0815-9319

issn

1440-1746

journal_volume

pub_type

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Close observation of gastric mucosal pattern by standard endoscopy can predict Helicobacter pylori infection status.