Endoscopic Kyoto and Kimura-Takemoto Classifications Are Comparable in Predicting High-Risk Gastric Precancerous Lesions.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestion Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.1159/000536048

Doan Thi Nha Nguyen, Duc Trong Quach, Quang Dinh Le, Nhu Thi Hanh Vu, Ngoc Le Bich Dang, Huy Minh Le, Nhan Quang Le, Shiro Oka, Shinji Tanaka, Toru Hiyama

{"title":"Endoscopic Kyoto and Kimura-Takemoto Classifications Are Comparable in Predicting High-Risk Gastric Precancerous Lesions.","authors":"Doan Thi Nha Nguyen, Duc Trong Quach, Quang Dinh Le, Nhu Thi Hanh Vu, Ngoc Le Bich Dang, Huy Minh Le, Nhan Quang Le, Shiro Oka, Shinji Tanaka, Toru Hiyama","doi":"10.1159/000536048","DOIUrl":null,"url":null,"abstract":"Introduction: Severe and extensive gastric atrophy, extensive or incomplete gastric intestinal metaplasia, and gastric dysplasia are considered high-risk gastric precancerous lesions (HGPLs). Endoscopic findings based on the endoscopic Kyoto classification (EKC) and the Kimura-Takemoto classification (KTC) have been reported to be significantly associated with HGPLs. This study aimed to compare these two classifications in predicting active Helicobacter pylori (H. pylori) infection and HGPLs.Methods: This is a cross-sectional study conducted on naïve dyspeptic patients who underwent upper gastrointestinal endoscopy at a tertiary hospital. Endoscopic findings were scored according to the EKC and KTC. Mapping biopsies were taken, and H. pylori infection was determined using a locally validated rapid urease test and histology. The performance of EKC was compared with that of KTC using the area under the receiver operating characteristic curve (AUC) in predicting active H. pylori infection and HGPLs.Results: There were 292 patients with a median age of 46 and a male-to-female ratio of 1:1. The rates of active H. pylori infection and HGPLs were 61.3% and 14.0%, respectively. The EKC was better than the KTC in predicting active H. pylori infection (AUC: 0.771 vs. 0.658, respectively; p < 0.001). However, these two classifications had comparable performance in predicting HGPLs (AUC: 0.792 vs. 0.791, respectively; p = 0.956).Conclusion: Compared to EKC, KTC is inferior in predicting active H. pylori infection but has comparable performance in predicting HGPLs.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"140-148"},"PeriodicalIF":3.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000536048","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Severe and extensive gastric atrophy, extensive or incomplete gastric intestinal metaplasia, and gastric dysplasia are considered high-risk gastric precancerous lesions (HGPLs). Endoscopic findings based on the endoscopic Kyoto classification (EKC) and the Kimura-Takemoto classification (KTC) have been reported to be significantly associated with HGPLs. This study aimed to compare these two classifications in predicting active Helicobacter pylori (H. pylori) infection and HGPLs.

Methods: This is a cross-sectional study conducted on naïve dyspeptic patients who underwent upper gastrointestinal endoscopy at a tertiary hospital. Endoscopic findings were scored according to the EKC and KTC. Mapping biopsies were taken, and H. pylori infection was determined using a locally validated rapid urease test and histology. The performance of EKC was compared with that of KTC using the area under the receiver operating characteristic curve (AUC) in predicting active H. pylori infection and HGPLs.

Results: There were 292 patients with a median age of 46 and a male-to-female ratio of 1:1. The rates of active H. pylori infection and HGPLs were 61.3% and 14.0%, respectively. The EKC was better than the KTC in predicting active H. pylori infection (AUC: 0.771 vs. 0.658, respectively; p < 0.001). However, these two classifications had comparable performance in predicting HGPLs (AUC: 0.792 vs. 0.791, respectively; p = 0.956).

Conclusion: Compared to EKC, KTC is inferior in predicting active H. pylori infection but has comparable performance in predicting HGPLs.

查看原文本刊更多论文

在预测高风险胃癌前病变方面，内镜京都分级和木村泷本分级具有可比性。

背景/目的：严重和广泛的胃萎缩、广泛或不完全的胃肠化生以及胃发育不良被认为是高风险胃癌前病变（HGPLs）。据报道，基于内镜京都分类法（EKC）和木村-竹本分类法（KTC）的内镜检查结果与 HGPLs 显著相关。本研究旨在比较这两种分类在预测活动性幽门螺杆菌（H. pylori）感染和 HGPLs 方面的作用：这是一项横断面研究，对象是在一家三甲医院接受上消化道内镜检查的天真消化不良患者。根据 EKC 和 KTC 分类对内镜检查结果进行评分。采集映射活组织切片，使用当地验证的快速尿素酶测试和组织学方法确定幽门螺杆菌感染情况。在预测活动性幽门螺杆菌感染和 HGPLs 方面，使用接收器操作特征曲线下面积（AUC）比较了 EKC 和 KTC 的性能：共有 292 名患者，中位年龄为 46 岁，男女比例为 1:1。活动性幽门螺杆菌感染率和 HGPLs 感染率分别为 61.3% 和 14.0%。在预测活动性幽门螺杆菌感染方面，EKC 优于 KTC（AUC：分别为 0.771 和 0.658；P< 0.001）。然而，这两种分类在预测 HGPLs 方面的表现相当（AUC：分别为 0.792 vs. 0.791；p = 0.956）：结论：与 EKC 相比，KTC 在预测活动性幽门螺杆菌感染方面较差，但在预测 HGPL 方面性能相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Digestion 医学-胃肠肝病学

CiteScore

7.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.