Diagnosis by combination of endoscopic findings helps differentiate non-Helicobacter pylori Helicobacter-infected gastritis from Helicobacter pylori-infected gastritis

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2024-03-21 DOI:10.1111/hel.13070

Takuma Okamura, Yugo Iwaya, Tadanobu Nagaya, Kazuki Horiuchi, Tatsuya Negishi, Hiroyoshi Ota, Takeji Umemura

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引用次数: 0

Abstract

Background

The characteristic endoscopic findings of non-Helicobacter pylori Helicobacter (NHPH) gastritis, including white marbled appearance and crack-like mucosa, have been reported. However, these findings can also manifest in H. pylori (HP)-infected gastritis. This study compared NHPH gastritis and mild atrophic HP gastritis to identify features that may enhance NHPH diagnosis.

Materials and Methods

A total of 2087 patients underwent upper gastrointestinal endoscopy and were histologically evaluated by multiple gastric mucosal biopsies according to the updated Sydney System (USS) at Shinshu University Hospital between 2005 and 2023. Among them, nine patients were classified into the NHPH group and 134 patients with HP infection and mild atrophy were classified into the HP group for retrospective comparisons of endoscopic findings and clinicopathological characteristics.

Results

All nine patients in the NHPH group (eight males [89%], median ± standard deviation [SD] age: 49 ± 13.0 years) were infected with H. suis. The 134 patients in the HP group contained 70 men (52%) and had a median ± SD age of 35 ± 19.9 years. Endoscopic findings were statistically comparable for white marbled appearance (three patients [33%] in the NHPH group and 37 patients [31%] in the HP group) and crack-like mucosa (three patients [33%] and 27 patients [20%], respectively). Diffuse redness was significantly less frequent in the NHPH group (one patient [14%] vs. 97 patients [72%], p < 0.001). White marbled appearance or crack-like mucosa without diffuse redness was significantly more common in the NHPH group (56% vs. 13%, p = 0.004), with a sensitivity and specificity of 56% and 87%, respectively. Mean USS neutrophil infiltration and Helicobacter density scores were significantly higher in the HP group (both p < 0.01), which might have influenced the endoscopic findings of diffuse redness.

Conclusions

When endoscopic findings of white marbled appearance or cracked-like mucosa are present, evaluation for diffuse redness may contribute to a more accurate diagnosis of NHPH gastritis.

查看原文本刊更多论文

结合内镜检查结果进行诊断有助于区分非幽门螺旋杆菌感染性胃炎和幽门螺旋杆菌感染性胃炎。

背景：非幽门螺杆菌胃炎（NHPH）的特征性内镜检查结果，包括白色大理石样外观和裂纹状粘膜，已被报道过。然而，幽门螺杆菌（HP）感染性胃炎也会出现这些症状。本研究比较了NHPH胃炎和轻度萎缩性HP胃炎，以确定可增强NHPH诊断的特征：2005年至2023年间，共有2087名患者在信州大学医院接受了上消化道内镜检查，并根据最新的悉尼系统（USS）进行了多次胃黏膜活检的组织学评估。其中，9 名患者被归入 NHPH 组，134 名感染 HP 且轻度萎缩的患者被归入 HP 组，对内镜检查结果和临床病理特征进行回顾性比较：NHPH组的9名患者（8名男性[89%]，中位数±标准差[SD]年龄：49±13.0岁）均感染了猪链球菌。HP组的134名患者中有70名男性（52%），年龄中位数±标准差（SD）为35±19.9岁。内镜检查结果在白色大理石花纹外观（NHPH 组有 3 名患者[33%]，HP 组有 37 名患者[31%]）和裂纹状粘膜（分别有 3 名患者[33%]和 27 名患者[20%]）方面具有统计学可比性。弥漫性发红在 NHPH 组明显较少（1 名患者 [14%] 对 97 名患者 [72%]，P 结论）：当内镜检查发现粘膜出现白色大理石花纹或裂纹时，对弥漫性发红进行评估有助于更准确地诊断 NHPH 胃炎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.