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Diagnosis by combination of endoscopic findings helps differentiate non-Helicobacter pylori Helicobacter-infected gastritis from Helicobacter pylori-infected gastritis.
Okamura, Takuma; Iwaya, Yugo; Nagaya, Tadanobu; Horiuchi, Kazuki; Negishi, Tatsuya; Ota, Hiroyoshi; Umemura, Takeji.
Afiliación
  • Okamura T; Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Iwaya Y; Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Nagaya T; Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan.
  • Horiuchi K; Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
  • Negishi T; Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
  • Ota H; Department of Biomedical Laboratory Sciences, School of Health Sciences, Shinshu University School of Medicine, Matsumoto, Japan.
  • Umemura T; Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.
Helicobacter ; 29(2): e13070, 2024.
Article en En | MEDLINE | ID: mdl-38514917
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Helicobacter / Gastritis Límite: Adolescent / Adult / Humans / Male / Middle aged Idioma: En Revista: Helicobacter Asunto de la revista: BACTERIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Helicobacter pylori / Infecciones por Helicobacter / Helicobacter / Gastritis Límite: Adolescent / Adult / Humans / Male / Middle aged Idioma: En Revista: Helicobacter Asunto de la revista: BACTERIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido