Accuracy of Endoscopic Diagnosis for Mild Atrophic Gastritis Infected with Helicobacter pylori.
- Author:
Takuma OKAMURA
1
;
Yugo IWAYA
;
Kei KITAHARA
;
Tomoaki SUGA
;
Eiji TANAKA
Author Information
- Publication Type:Original Article
- Keywords: Diagnostic accuracy; Endoscopic diagnosis; Helicobacter pylori; Mild atrophy
- MeSH: Atrophy; Carcinogenesis; Diagnosis*; Endoscopy; Gastritis, Atrophic*; Helicobacter pylori*; Helicobacter*; Humans; Japan; Venules
- From:Clinical Endoscopy 2018;51(4):362-367
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: This study examined the accuracy of endoscopic evaluation for determining the Helicobacter pylori infection status in patients with mild atrophy who might not exhibit characteristic endoscopic findings. METHODS: Forty endoscopists determined the H. pylori infection status of 50 randomly presented H. pylori-positive and H. pylori-negative cases on the basis of a list of established findings. RESULTS: The median clinical endoscopy experience was 7 years (range, 1–35 years), including 22 board-certified endoscopists (55%) of the Japan Gastroenterological Endoscopy Society. The mean accuracy rate of endoscopic diagnosis was 67% and was unrelated to experience status (experienced vs. trainee: 69% vs. 65%, p=0.089) and total years of experience (R 2 =0.022). The most frequently selected endoscopic findings were regular arrangement of collecting venules (59%), atrophy (45%), and red streak (22%), which had fair accuracy rates of 67%, 65%, and 73%, respectively. By contrast, the accuracy rates of nodularity (89%) and mucosal swelling (77%) were highest. The 20 endoscopists who more frequently identified these findings diagnosed H. pylori infection significantly more accurately than did the other endoscopists (71% vs. 64%, p=0.008). CONCLUSIONS: Careful attention to nodularity and mucosal swelling in patients with mild atrophy may enhance diagnosis, enable prompt treatment, and avoid possible long-term carcinogenesis.
