Usefulness of the Kyoto Classification Score for Prediction of Current Helicobacter pylori Infection

Abstract

Background/Aims: Based on the Kyoto classification of gastritis, mucosal atrophy, endoscopic intestinal metaplasia, fold enlargement, nodularity, and diffuse redness may be associated with gastric cancer and Helicobacter pylori ( H. pylori ) infection. In this study, we investigated the association between Kyoto scores based on the aforementioned five variables and current H. pylori infection. Materials and Methods: We reviewed medical records of consecutive patients who underwent endoscopic biopsies between January and June 2019. The study included 687 patients (370 and 317 patients with H. pylori- negative and -positive results, respectively). The Kyoto score was evaluated by the endoscopist who performed the test and was reconfirmed by another endoscopist. The total Kyoto score was analyzed using a receiver operating characteristic (ROC) curve for each score from 0 to 8. Multivariate analysis was used to determine the variables associated with H. pylori infection. Results: The maximum value of the Youden index (which reflects the ideal cut-off score of the Kyoto score on the ROC curve) was a Kyoto score of 2 points (Youden index 0.5905). Nodularity (OR 24.69, 95% CI 8.57~71.16, P <0.001) and diffuse redness (1 point: OR 18.29, 95% CI 10.29~32.52, P <0.001 and 2 points: OR 30.82, 95% CI 14.07~67.52, P <0.001) showed the highest OR on multivariate analysis. Conclusions: A Kyoto classification cut-off score of 2 points was suggestive of H. pylori infection, and mucosal nodularity and diffuse redness were most significantly associated with the risk of infection. (Korean J Helicobacter Up Gastrointest Res 2022;22:281-287)