Nodularity-like appearance in the cardia: novel endoscopic findings for Helicobacter pylori infection

Toyoshima, Osamu; Nishizawa, Toshihiro; Sakitani, Kosuke; Yamakawa, Tadahiro; Watanabe, Hidenobu; Yoshida, Shuntaro; Nakai, Yousuke; Hata, Keisuke; Ebinuma, Hirotoshi; Suzuki, Hidekazu; Koike, Kazuhiko

doi:10.1055/a-1136-9890

Cited by 15 publications

(17 citation statements)

References 33 publications

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“…Our previous study showed excellent prediction accuracy of cardiac nodularity due to H. pylori infection, with 0.928 of accuracy, 0.996 of specificity, 0.571 of sensitivity, 0.960 of positive predictive value, and 0.925 of negative predictive value[ 18 ]. In our previous study, we included only the patients who were evaluated for H pylori infection for the first time, and excluded patients with a history of eradication.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously reported that nodularity could occur in both the antrum and the cardia[ 18 ]. Cardiac nodularity-like appearance is found more frequently than antral nodularity.…”

Section: Introductionmentioning

confidence: 99%

“…Our previous report also showed excellent interobserver agreement on cardiac nodularity. Furthermore, histological examination of cardiac nodularity often revealed lymphoid follicles displaying lymphocyte infiltration in the cardiac gland[ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection

Nishizawa

Sakitani

Suzuki

et al. 2020

WJG

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BACKGROUND We have previously reported that Helicobacter pylori ( H. pylori )-associated nodular gastritis could occur in both the antrum and the cardia. Cardiac nodularity-like appearance (hereafter, called as cardiac nodularity) had a high predictive accuracy for the diagnosis of H. pylori infection. In the previous study, we included only the patients who were evaluated for H. pylori infection for the ﬁrst time, and excluded patients with a history of eradication. Therefore, the prevalence and clinical features of cardiac nodularity remains unknown. AIM To perform this cross-sectional study to explore the characteristics of cardiac nodularity. METHODS Consecutive patients who underwent esophagogastroduodenoscopy between May, 2017 and August, 2019 in the Toyoshima Endoscopy Clinic were enrolled in this study. We included H. pylori -negative, H. pylori -positive, and H. pylori -eradicated patients, and excluded patients with unclear H. pylori status and eradication failure. H. pylori infection was diagnosed according to serum anti- H. pylori antibody and the urea breath test or histology. Cardiac nodularity was defined as a miliary nodular appearance or the presence of scattered whitish circular small colorations within 2 cm of the esophagogastric junction. Nodularity was visualized as whitish in the narrow-band imaging mode. We collected data on the patients’ baseline characteristics. RESULTS A total of 1078 patients were finally included. Among H. pylori -negative patients, cardiac nodularity and antral nodularity were recognized in 0.14% each. Among H. pylori -positive patients, cardiac nodularity and antral nodularity were recognized in 54.5% and 29.5%, respectively. Among H. pylori -eradicated patients, cardiac nodularity and antral nodularity were recognized in 4.5% and 0.6%, respectively. The frequency of cardiac nodularity was significantly higher than that of antral nodularity in H. pylori -positive and -eradicated patients. The frequencies of cardiac nodularity and antral nodularity in H. pylori -eradicated patients were significantly lower than those in H. pylori -positive patients ( P < 0.001). The patients with cardiac nodularity were significantly younger than those without cardiac nodularity ( P = 0.0013). Intestinal metaplasia score of the patients with cardiac nodularity were significantly lower than those without cardiac nodularity ( P = 0.0216). Among H. pylori ...

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Section: Discussionmentioning

confidence: 99%

“…We have previously reported that nodularity could occur in both the antrum and the cardia[ 18 ]. Cardiac nodularity-like appearance is found more frequently than antral nodularity.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection

Nishizawa

Sakitani

Suzuki

et al. 2020

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“…[16][17][18] Endoscopy is essential to diagnose gastritis, evaluate the presence or absence of H. pylori infection, and assess the risk of gastric cancer. [19][20][21] The Kyoto classification of gastritis is an endoscopy-based classification proposed by the Japan Gastroenterological Endoscopy Society in 2013. It was introduced to estimate the risk of H. pylori infection and gastric cancer on endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylorieradication improved the Kyoto classification score on endoscopy

et al. 2020

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Background and Aim: Endoscopy-based Kyoto classification predicts the risk of Helicobacter pylori infection and gastric cancer; however, the change in score following H. pylori eradication remains unknown. We retrospectively compared the Kyoto score before and after H. pylori eradication. Methods: H. pylori-positive patients who underwent baseline esophagogastroduodenoscopy (EGD), successful H. pylori eradication, and surveillance EGD were enrolled. The Kyoto score is a sum of scores for atrophy (Kimura-Takemoto atrophicborder classification none or C1: 0, C-II or C-III: 1

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“…We obtained biopsy specimens from two sites, the greater curvature of the corpus and the antrum[ 25 ]. One experienced gastrointestinal pathologist diagnosed neutrophil activity score based on the updated Sydney System in hematoxylin and eosin staining.…”

Section: Methodsmentioning

confidence: 99%

Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity

Toyoshima¹,

Nishizawa²,

Yoshida³

et al. 2020

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BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer risk. AIM To investigate the association between Kyoto classification and the topographic distribution of neutrophil activity. METHODS Kyoto classification score, ranging from 0 to 8, consisted of atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness. Neutrophil activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the antrum. The participants were divided into four categories, inactive stomach, antrum-predominant gastritis, pangastritis, and corpus-predominant gastritis, based on the topographic distribution of neutrophil activity. Effects of sex, age, body mass index, drinking habit, smoking habit, family history of gastric cancer, serum Helicobacter pylori ( H. pylori ) antibody, and Kyoto score on topography of neutrophil infiltration were analyzed. RESULTS A total of 327 patients (comprising 50.7% women, with an average age of 50.2 years) were enrolled in this study. H. pylori infection rate was 82.9% with a mean Kyoto score of 4.63. The Kyoto score was associated with the topographic distribution of neutrophil activity. Kyoto scores were significantly higher in the order of inactive stomach, antrum-predominant gastritis, pangastritis, and corpus-predominant gastritis (3.05, 4.57, 5.21, and 5.96, respectively). Each individual score of endoscopic findings ( i.e ., atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) was correlated with the topographic distribution of neutrophil activity. On multivariate analysis, the Kyoto score, age, and serum H. pylori antibody were independently associated with the topographic distribution of neutrophil activity. CONCLUSION The Kyoto classification score was associated with the topographic distribution of neutrophil activity.

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Nodularity-like appearance in the cardia: novel endoscopic findings for Helicobacter pylori infection

Cited by 15 publications

References 33 publications

Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection

Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection

Helicobacter pylorieradication improved the Kyoto classification score on endoscopy

Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity

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