Endoscopic Characteristics of Rugal Hyperplasia and Related Acid Condition in Helicobacter pylori-Infected Stomach
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Background/Aims: Rugal hyperplastic gastritis (RHG) is associated with Lauren’s diffuse-type gastric cancer (GC) and theaccompanying active inflammation is linked to gastric hypoacidity. We tried to establish the steps for identifying high-risk GCpatients. Methods: We included 196 patients with confirmed Helicobacter pylori infection by rapid urease test during screening endoscopy forhealth check-up from January 2016 to September 2016; all patients underwent blood tests for pepsinogen I and II and fasting serumgastrin. We compared RHG findings with various other endoscopic mucosal images. We also evaluated the relationships betweenRHG and other mucosal aspects for a given acid status based on serological markers. Results: Hypoacid and ultra-low-acid (67%) statuses were dominant, with only 18% hyperacid patients. RHG with high acid wasrelated to a less atrophic body type (p=0.001), and RHG with ultra-low acid was associated with body xanthoma (p=0.029) andincreased serum gastrin level (p=0.038). However, RHG’s influence on gastric acidity was only seen in closed-type endoscopicatrophic border (EAB), not in open type (p=0.001). Conclusions: The majority of RHG patients had hypoacid status. RHG frequency showed no difference between closed and opentypeEAB, but gastric acidity was influenced by RHG only in closed-type EAB.
Abstract
Background/Aims: Rugal hyperplastic gastritis (RHG) is associated with Lauren’s diffuse-type gastric cancer (GC) and theaccompanying active inflammation is linked to gastric hypoacidity. We tried to establish the steps for identifying high-risk GCpatients. Methods: We included 196 patients with confirmed Helicobacter pylori infection by rapid urease test during screening endoscopy forhealth check-up from January 2016 to September 2016; all patients underwent blood tests for pepsinogen I and II and fasting serumgastrin. We compared RHG findings with various other endoscopic mucosal images. We also evaluated the relationships betweenRHG and other mucosal aspects for a given acid status based on serological markers. Results: Hypoacid and ultra-low-acid (67%) statuses were dominant, with only 18% hyperacid patients. RHG with high acid wasrelated to a less atrophic body type (p=0.001), and RHG with ultra-low acid was associated with body xanthoma (p=0.029) andincreased serum gastrin level (p=0.038). However, RHG’s influence on gastric acidity was only seen in closed-type endoscopicatrophic border (EAB), not in open type (p=0.001). Conclusions: The majority of RHG patients had hypoacid status. RHG frequency showed no difference between closed and opentypeEAB, but gastric acidity was influenced by RHG only in closed-type EAB.
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