Literature DB >> 20101778

Mucosal patterns of Helicobacter pylori-related gastritis without atrophy in the gastric corpus using standard endoscopy.

Sheng-Lei Yan1, Shwu-Tzy Wu, Chien-Hua Chen, Yeh-Huang Hung, Tsung-Hsun Yang, Vun-Siew Pang, Yung-Hsiang Yeh.   

Abstract

AIM: To identify the mucosal patterns of Helicobacter pylori (H. pylori)-related gastritis in the gastric corpus using standard endoscopy and to evaluate their reproducibility.
METHODS: A total of 112 consecutive patients underwent upper gastrointestinal endoscopy. The endoscopists classified the endoscopic findings into 4 patterns. In the second part of the study, 90 images were shown to 3 endoscopists in order to evaluate the inter-observer and intra-observer variability in image assessment.
RESULTS: The mucosal patterns of the gastric body were categorized into 4 types. Type 1 pattern was defined as cleft-like appearance, type 2 as regular arrangement of red dots, type 3 pattern as the mosaic mucosal pattern and type 4 pattern as the mosaic pattern with a focal area of hyperemia. Type 1 and type 2 mucosal patterns were statistically significant in predicting H. pylori-negative status as compared with other mucosal types (chi(2) = 12.79 and 61.25 respectively, P < 0.01). Type 3 and type 4 mucosal patterns were statistically significant in predicting a H. pylori-positive status as compared with other mucosal types (chi(2) = 21.22 and 11.02 respectively, P < 0.01). Furthermore, the sensitivity, specificity, positive and negative predictive values of type 3 plus type 4 patterns for predicting H. pylori-positive gastric mucosa were 100%, 86%, 94%, and 100%, respectively. The mean kappa values for inter- and intra-observer agreement in assessing the various endoscopic patterns were 0.808 (95% CI, 0.678-0.938) and 0.826 (95% CI, 0.727-0.925) respectively.
CONCLUSION: Our study suggests that mucosal patterns in H. pylori-infected gastric mucosa without atrophy can be reliably identified using standard endoscopy in the gastric corpus.

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Year:  2010        PMID: 20101778      PMCID: PMC2811805          DOI: 10.3748/wjg.v16.i4.496

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


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