Accuracy of Endoscopic Diagnosis for Mild Atrophic Gastritis Infected with Helicobacter pylori

Okamura, Takuma; Iwaya, Yugo; Kitahara, Kei; Suga, Tomoaki; Tanaka, Eiji

doi:10.5946/ce.2017.177

Cited by 20 publications

(25 citation statements)

References 18 publications

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“…The vast majority of studies report a fair agreement between the endoscopic and histological diagnosis of gastritis, particularly in children and support the routine collection of biopsy samples during endoscopy in pediatric patients [20][21][22]. This high discrepancy might stem from the differences in the geographic distribution of H. pylori infection and not necessarily from the endoscopist's experience [23]. In contrast to other studies, the Cohen's k coefficient of 0.42 determined in our analysis indicates a good agreement between the two methods; this could be explained by the high prevalence of infection in our country.…”

Section: Discussionmentioning

confidence: 93%

Helicobacter pylori Gastritis in Children—The Link between Endoscopy and Histology

Domșa

Lupușoru

Gheban

et al. 2020

JCM

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Background: The management of Helicobacter pylori (H. pylori) infection raises important challenges, still being the most common chronic infection worldwide in all age groups. In high-prevalence regions, paediatric patients need a specific focus, as the acquisition of the infection takes place in childhood. The objective of this study was to analyze the endoscopic and histopathologic changes of the gastric mucosa in H. pylori infected children. Material and Methods: A retrospective study was performed on consecutive paediatric patients, ranging from 0 to 18 years of age, who underwent an upper gastrointestinal endoscopy (UGE) for a period of 5 years, regardless of their symptomatology. Endoscopy reports and histological slides were reviewed and clinical, endoscopic, and histologic data were recorded. Results: A total of 248 patients were included in the study, 82 (33.06%) of them being H. pylori infected. There was no difference in age and symptoms between the infected and noninfected group. A significant association was found between the H. pylori infection and histopathological parameters such as acute and chronic inflammatory infiltrate. The bacterial load influences the intensity of inflammation (p < 0.001). The chronic inflammation was predominant, only 23.2% of the patients displayed acute inflammation (p < 0.0001). The topographic distribution of inflammation was dominated by pangastritis (p = 0.04) with 58.6% of the patients presenting similar degrees of inflammation both in the antrum and corpus. Conclusion: Endoscopic features such as nodularity of the antral mucosa (p < 0.05) along with histological findings as lymphoid follicles (p < 0.05) are suggestive of H. pylori infection. However, the concordance between the endoscopic and histological diagnosis is still far from perfect (Cohen’s k coefficient = 0.42), maintaining the need for an invasive approach in children.

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Section: Discussionmentioning

confidence: 93%

Helicobacter pylori Gastritis in Children—The Link between Endoscopy and Histology

Domșa

Lupușoru

Gheban

et al. 2020

JCM

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“…Okamura et al [15] reported that the accuracy of endoscopic diagnoses of H. pylori infections in patients with mild atrophic gastritis was approximately 67%. There was no significant difference in the accuracy rate between experienced endoscopists and trainees.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…The summarized numerical data were expressed as medians with SDs and compared using Student t tests. Fleiss' κ was used to evaluate the inter-observer agreement [14,15]. A p value of < 0.05 in each analysis was considered statistically significant.…”

Section: Sample Sizementioning

confidence: 99%

Accuracies of Endoscopic Diagnosis of Helicobacter pylori-Gastritis: Multicenter Prospective Study Using White Light Imaging and Linked Color Imaging

et al. 2019

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Introduction: The diagnosis of Helicobacter pylori infection status with white light imaging (WLI) is difficult. We evaluated the accuracies of using WLI and linked color imaging (LCI) for diagnosing H. pylori-active gastritis in a multicenter prospective study setting. Methods: Patients who underwent esophagogastroduodenoscopy were prospectively included. The image collection process was randomized and anonymous, and the image set included 4 images with WLI or 4 images with LCI in the corpus that 5 reviewers separately evaluated. Active gastritis was defined as positive when there was diffuse redness in WLI and crimson coloring in LCI. The H. pylori infection status was determined by the urea breath test and the serum antibody test. Cases in which both test results were negative but atrophy or intestinal metaplasia was histologically confirmed were defined as past infections. The primary endpoint was the diagnostic accuracies of WLI and LCI, and the secondary endpoint was inter-observer agreement. Results: Data for 127 patients were analyzed. The endoscopic diagnostic accuracy for active gastritis was 79.5 (sensitivity of 84.4 and specificity of 74.6) with WLI and 86.6 (sensitivity of 84.4 and specificity of 88.9) with LCI (p = 0.029). LCI significantly improved the accuracy in patients with past infections over WLI (36.8 in WLI and 78.9 in LCI, p < 0.01). The κ values were 0.59 in WLI and 0.70 in LCI. Conclusions: LCI is useful for endoscopic diagnosis of H. pylori-active or inactive gastritis, and it is advantageous for patients with past infections of inactive gastritis.

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“…At endoscopy, gastritis is described as any reddening or edema of the gastric mucosa, but neither of these endoscopic features is specific or exclusive to mucosal inflammation. A Japanese study on the accuracy of standard endoscopic imaging for the detection of H. pylori infection reported accuracy of 89% for nodularity and 77% for mucosal swelling [3].…”

Section: Introductionmentioning

confidence: 99%

Gastritis: An Update in 2020

Sugano

Sacchi

Sbaraglia

et al. 2020

Curr Treat Options Gastro

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Purpose of review The gastritis constellation includes heterogeneous clinicopathological entities, among which long-standing, non-self-limiting gastritis, mainly due to Helicobacter pylori infection, has been epidemiologically, biologically, and clinically linked to gastric cancer development (i.e. “inflammation-associated cancer”). This review illustrates the updated criteria applied in the taxonomy of gastritis (Kyoto classification), elucidates the biological rationale for endoscopy biopsy sampling (heterogeneity of gastric mucosa), and finally reports the results of long-term follow-up studies supporting the reliability of biopsy-based gastritis staging as predictor of gastritis-associated cancer risk. Recent findings By assuming gastric atrophy as the “cancerization field” where (non-syndromic) gastric cancer mostly develops, recent long-term follow-up studies consistently demonstrate the prognostic impact of the gastritis OLGA staging system. Summary Helicobacter pylori eradication is the leading strategy in the primary prevention of gastric cancer. In a multidisciplinary dimension of secondary cancer prevention, the OLGA staging system reliably ranks the patient-specific cancer risk, thus providing the clinical rationale for a tailored follow-up strategy.

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Accuracy of Endoscopic Diagnosis for Mild Atrophic Gastritis Infected with Helicobacter pylori

Cited by 20 publications

References 18 publications

Helicobacter pylori Gastritis in Children—The Link between Endoscopy and Histology

Helicobacter pylori Gastritis in Children—The Link between Endoscopy and Histology

Accuracies of Endoscopic Diagnosis of Helicobacter pylori-Gastritis: Multicenter Prospective Study Using White Light Imaging and Linked Color Imaging

Gastritis: An Update in 2020

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