Validity of endoscopic features for the diagnosis ofHelicobacter pyloriinfection status based on the Kyoto classification of gastritis

Abstract

ObjectivesEvaluation of Helicobacter pylori infection status (non‐infection, past infection, current infection) has become important. This study aimed to determine the usefulness of the Kyoto classification of gastritis for diagnosing H. pylori infection status by endoscopy.MethodsIn this prospective study, 498 subjects were recruited. Seven well‐experienced endoscopists blinded to the history of eradication therapy performed the examinations. Endoscopic findings were assessed according to the Kyoto classification of gastritis: diffuse redness, regular arrangement of collecting venules (RAC), fundic gland polyp (FGP), atrophy, xanthoma, hyperplastic polyp, map‐like redness, intestinal metaplasia, nodularity, mucosal swelling, white and flat elevated lesion, sticky mucus, depressive erosion, raised erosion, red streak, and enlarged folds. We established prediction models according to a machine learning procedure and compared them with general assessment by endoscopists using the Kyoto classification of gastritis.ResultsSignificantly higher diagnostic odds were obtained for RAC (32.2), FGP (7.7), and red streak (4.7) in subjects with non‐infection, map‐like redness (12.9) in subjects with past infection, and diffuse redness (26.8), mucosal swelling (13.3), sticky mucus (10.2) and enlarged fold (8.6) in subjects with current infection. The overall diagnostic accuracy rate was 82.9% with the Kyoto classification of gastritis. The diagnostic accuracy of the prediction model was 88.6% for the model without H. pylori eradication history and 93.4% for the model with eradication history.ConclusionsThe Kyoto classification of gastritis is useful for diagnosing H. pylori infection status based on endoscopic findings. Our prediction model is helpful for novice endoscopists. (UMIN000016674).

Can image‐enhanced endoscopy improve the diagnosis of Kyoto classification of gastritis in the clinical setting?

“…CAD has also been studied with Kyoto classification of gastritis for endoscopic diagnosis of H. pylori infection. The prediction model by a machine learning procedure using the combination of endoscopic features in the Kyoto classification of gastritis demonstrated high diagnostic accuracy of H. pylori infection status the same as that by the experienced endoscopists’ assessments …”

“…Kyoto classification of gastritis has been developed to evaluate H. pylori infection status and assess the risk of gastric cancer more accurately. The combination diagnosis using the endoscopic features in the Kyoto classification of gastritis demonstrated a high diagnostic accuracy of H. pylori infection status by endoscopists . The total score of the grading system according to this classification was useful to evaluate the risk of gastric cancer for active H. pylori gastritis .…”

“…The combination diagnosis using the endoscopic features in the Kyoto classification of gastritis demonstrated a high diagnostic accuracy of H. pylori infection status by endoscopists. 33 The total score of the grading system according to this classification was useful to evaluate the risk of gastric cancer for active H. pylori gastritis. 28,34 However, the total score of this grading system after H. pylori eradication therapy may not reflect the accurate risk of gastric cancer because of the disappearance of diffuse redness, nodularity, and enlarged folds.…”

“…The endoscopic diagnosis using WLI according to the Kyoto classification of gastritis demonstrated a high diagnostic accuracy of H. pylori infection by endoscopists in a prospective study. 33 Therefore, further prospective studies should be conducted to validate the usefulness of these IEEs for the Kyoto classification of gastritis.…”

Endoscopy opens the door to a new era of autoimmune gastritis research

“…As the authors formed the AIG research committee and were familiar with the endoscopic characteristics of the condition, it is unsurprising that endoscopy enabled the diagnosis of AIG . Regarding clinical practice for atrophic gastritis, the Kyoto Classification of Gastritis is used in many Japanese institutes and clinics to describe and categorize H. pylori associated‐gastritis (current or past infection) . This nationwide awareness of the endoscopic appearance of gastritis facilitates the detection of uncommon (i.e.…”