Regular arrangement of collecting venules and the Kimura-Takemoto classification for the endoscopic diagnosis of Helicobacter pylori infection: Evaluation in a Western setting.
Helicobacter pylori
endoscopy
gastroscopy
infection
stomach
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
29
07
2020
received:
24
05
2020
accepted:
04
08
2020
pubmed:
9
8
2020
medline:
29
7
2021
entrez:
9
8
2020
Statut:
ppublish
Résumé
The regular arrangement of collecting venules (RAC) and the Kimura-Takemoto classification of atrophic change (KTC) are simple and easy-to-use criteria which have been shown to reliably predict or rule out a Helicobacter pylori infection of the stomach. Although these features have been investigated extensively in Asia, their significance in the West has not been evaluated. In a series of 200 consecutive gastroscopic examinations (single examiner, single center), the presence or absence of RAC and the KTC grade (open type vs closed type) were recorded prospectively. Helicobacter pylori infection was defined as a positive histology or a positive rapid urease test. Furthermore, multivariate analysis of endoscopic predictors of H. pylori infection based on the Kyoto classification of gastritis was performed. Two hundred patients were examined of which 57 had a H. pylori infection (28%). Both RAC and KTC had excellent negative predictive values of about 90% and sensitivity values of up to 85%. In multivariate analysis, atrophic change and diffuse redness without RAC were significantly associated with H. pylori infection. Regular arrangement of collecting venules and KTC are simple endoscopic features which should be given attention by Western endoscopists and can be easily used to rule out a H. pylori infection of the stomach.
Sections du résumé
BACKGROUND
BACKGROUND
The regular arrangement of collecting venules (RAC) and the Kimura-Takemoto classification of atrophic change (KTC) are simple and easy-to-use criteria which have been shown to reliably predict or rule out a Helicobacter pylori infection of the stomach. Although these features have been investigated extensively in Asia, their significance in the West has not been evaluated.
METHODS
METHODS
In a series of 200 consecutive gastroscopic examinations (single examiner, single center), the presence or absence of RAC and the KTC grade (open type vs closed type) were recorded prospectively. Helicobacter pylori infection was defined as a positive histology or a positive rapid urease test. Furthermore, multivariate analysis of endoscopic predictors of H. pylori infection based on the Kyoto classification of gastritis was performed.
RESULTS
RESULTS
Two hundred patients were examined of which 57 had a H. pylori infection (28%). Both RAC and KTC had excellent negative predictive values of about 90% and sensitivity values of up to 85%. In multivariate analysis, atrophic change and diffuse redness without RAC were significantly associated with H. pylori infection.
CONCLUSION
CONCLUSIONS
Regular arrangement of collecting venules and KTC are simple endoscopic features which should be given attention by Western endoscopists and can be easily used to rule out a H. pylori infection of the stomach.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
587-591Informations de copyright
© 2020 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.
Références
Yagi K, Nakamura A, Sekine A. Characteristic endoscopic and magnified endoscopic findings in the normal stomach without Helicobacter pylori infection. J Gastroenterol Hepatol 2002; 17: 39-45.
Cho JH, Chang YW, Jang JY et al. Close observation of gastric mucosal pattern by standard endoscopy can predict Helicobacter pylori infection status. J Gastroenterol Hepatol 2013; 28: 279-84.
Mao T, Wang Y, Yin F et al. Association of endoscopic features of gastric mucosa with Helicobacter pylori infection in Chinese patients. Gastroenterol Res Pract 2016; 2016: 6539639.
Watanabe K, Nagata N, Nakashima R et al. Predictive findings for Helicobacter pylori-uninfected, -infected and -eradicated gastric mucosa: Validation study. World J Gastroenterol 2013; 19: 4374-9.
Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969; 1: 87-97.
Sakae H, Iwamuro M, Okamoto Y et al. Evaluation of the usefulness and convenience of the Kyoto classification of gastritis in the endoscopic diagnosis of the Helicobacter pylori infection status. Digestion Published online: 19 Sep 2019; https://doi.org/10.1159/000502573
Toyoshima O, Nishizawa T, Koike K. Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis. World J Gastroenterol. 2020; 26: 466-77.
Yoshii S, Mabe K, Watano K et al. Validity of endoscopic features for the diagnosis of Helicobacter pylori infection status based on the Kyoto classification of gastritis. Dig Endosc 2020; 32: 74-83.
Sugimoto M, Ban H, Ichikawa H et al. Efficacy of the Kyoto classification of gastritis in identifying patients at high risk for gastric cancer. Intern Med 2017; 56: 579-86.
Michel A, Pawlita M, Boeing H, Gissmann L, Waterboer T. Helicobacter pylori antibody patterns in Germany: A cross-sectional population study. Gut Pathog 2014; 6: 10.
Fischbach W, Malfertheiner P, Lynen Jansen P et al. [S2k-guideline Helicobacter pylori and gastroduodenal ulcer disease] Z Gastroenterol 2016; 54: 327-63.
Zhou X-H, Obuchowski NA, McClish DK. Statistical Methods in Diagnostic Medicine, 2nd edn. Hoboken, NJ: John Wiley & Sons, 2011; 395-7.
Laine L, Estrada R, Trujillo M, Knigge K, Fennerty MB. Effect of proton-pump inhibitor therapy on diagnostic testing for Helicobacter pylori. Ann Intern Med 1998; 129: 547-50.
Murakami K, Sato R, Okimoto T et al. Influence of anti-ulcer drugs used in Japan on the result of (13)C-urea breath test for the diagnosis of Helicobacter pylori infection. J Gastroenterol 2003; 38: 937-41.