Map-Like Redness Development After Eradication Therapy for Helicobacter pylori Infection: Prospective Multicenter Observational Study

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2024-11-03 DOI:10.1111/hel.13146

Sho Matsumoto, Mitsushige Sugimoto, Tomohiro Terai, Yasuhiko Maruyama, Shu Sahara, Shigeru Kanaoka, Yashiro Yoshizawa, Shuhei Unno, Masaki Murata, Takahiro Uotani, Tomohiro Sugiyama, Shigemi Nakajima, Kiyoyuki Hayafuji, Ken Haruma, Tomoari Kamada, Masakatsu Fukuzawa, Takashi Kawai, Takao Itoi

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引用次数: 0

Abstract

Background

Map-like redness, pathological intestinal metaplasia, is observed in one-fourth to one-third of patients 1 year after Helicobacter pylori eradication therapy, mainly in the corpus, and is a newly identified endoscopic risk factor for gastric cancer development after eradication. However, it is unclear whether intestinal metaplasia is present before eradication at the site where the map-like redness appears. We aimed to identify endoscopic findings that predict the occurrence of map-like redness before H. pylori eradication.

Materials and Methods

As a prospective multicenter trial, the characteristics of patients in whom map-like redness developed after eradication, and the association between the endoscopic severity of gastritis and the development of map-like redness in patients who underwent endoscopy before and 1-year after eradication were investigated.

Results

The rate of map-like redness in all 93 patients 1-year postsuccessful eradication was 30.1% (95% confidence interval [CI]: 21.0–40.5). All patients with map-like redness were endoscopically observed to have intestinal metaplasia before eradication, in the site that subsequently developed map-like redness. Patients who developed map-like redness were older, had more severe intestinal metaplasia and nodularity and a higher total score on the Kyoto Classification of Gastritis both before and after eradication than patients who did not. On multivariate analysis, map-like redness was found to be associated with posttreatment intestinal metaplasia (odds ratio: 8.144; 95% CI: 2.811–23.592).

Conclusions

In all patients who developed map-like redness after eradication, endoscopic intestinal metaplasia was observed at the site developed map-like redness before eradication therapy. Map-like redness was especially observed in patients with more severe intestinal metaplasia at 1-year after eradication. Such patients require increased attention at surveillance endoscopy, owing to generally having a higher risk of gastric cancer development.

Trial Registration

University Hospital Medical Information Network: UMIN000044707

查看原文本刊更多论文

幽门螺杆菌感染根除疗法后出现的地图样红斑：前瞻性多中心观察研究。

背景：幽门螺杆菌根除治疗 1 年后，四分之一到三分之一的患者会出现地图样发红，即病理性肠化生，主要发生在胃体，这是新发现的根除后胃癌发生的内镜风险因素。然而，目前还不清楚在根除前出现地图样发红的部位是否存在肠化生。我们的目的是找出能预测幽门螺杆菌根除前出现地图样发红的内镜检查结果：作为一项前瞻性多中心试验，我们调查了根除幽门螺杆菌后出现地图样发红的患者特征，以及根除幽门螺杆菌前和根除幽门螺杆菌1年后接受内镜检查的患者的内镜下胃炎严重程度与出现地图样发红之间的关联：结果：所有93名患者在成功根除后1年出现地图样发红的比例为30.1%（95%置信区间[CI]：21.0-40.5）。所有出现地图样发红的患者均在根除前经内镜观察发现有肠化生，并在随后出现地图样发红的部位。与未出现地图样发红的患者相比，出现地图样发红的患者年龄更大，肠化生和结节更严重，根除前后的京都胃炎分类总分更高。多变量分析发现，地图样发红与治疗后肠化生有关（几率比：8.144；95% CI：2.811-23.592）：结论：在所有根除治疗后出现地图样发红的患者中，根除治疗前出现地图样发红的部位均可观察到内镜下肠化生。尤其是在根除治疗后 1 年，在肠化生更为严重的患者中观察到了地图样发红。由于这类患者发生胃癌的风险通常较高，因此需要在监测内镜检查时给予更多关注：试验注册：大学医院医学信息网：UMIN000044707.

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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.