| Prediction of Helicobacter pylori Infection Status via Close Observation of Gastric Mucosal Pattern by Standard Endoscopy |
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Kyunghan Yoon, Young Woon Chang, Jun Hyung Cho, Yu Ho Lee, Kwon Kee Kim, Tae Young Kim, Sung Hoon Hong, Weon Jin Ko, Jung Wook Kim, Jae Young Jang |
1Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea. cywgi@chollian.net
2Department of Internal Medicine, Soon Chun Hyang University Hospital Seoul, Seoul, Korea.
3Department of Internal Medicine, Gachon University Cheorwon Gil Hospital, Cheorwon, Korea. |
| 일반 내시경의 위점막 패턴 근접관찰로 Helicobacter pylori 감염 예측 가능성 연구 |
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윤경한, 장영운, 조준형1, 이유호, 김권기2, 김태영, 홍성훈, 고원진, 김정욱, 장재영 |
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경희대학교 의과대학 내과학교실, 순천향대학교 서울병원 내과1, 가천대 철원길병원 내과2 |
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| Abstract |
BACKGROUND/AIMS
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. MATERIALS AND METHODS: A total of 617 participants who underwent gastroscopy were prospectively enrolled from August 2011 to January 2012. We performed a careful close examination of the corpus at the greater curvature maintaining a distance < or =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 mixed 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 observation of the gastric mucosal pattern with standard endoscopy can predict H. pylori infection status. |
| Key Words:
Endoscopy; Helicobacter pylori; Stomach |
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