Accuracy of Endoscopic Diagnosis for Mild Atrophic Gastritis Infected with Helicobacter pylori
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초록
Background/Aims: This study examined the accuracy of endoscopic evaluation for determining the Helicobacter pylori infection statusin patients with mild atrophy who might not exhibit characteristic endoscopic findings. Methods: Forty endoscopists determined the H. pylori infection status of 50 randomly presented H. pylori-positive and H. pylorinegativecases on the basis of a list of established findings. Results: The median clinical endoscopy experience was 7 years (range, 1–35 years), including 22 board-certified endoscopists (55%) of theJapan Gastroenterological Endoscopy Society. The mean accuracy rate of endoscopic diagnosis was 67% and was unrelated to experiencestatus (experienced vs. trainee: 69% vs. 65%, p=0.089) and total years of experience (R2=0.022). The most frequently selected endoscopicfindings were regular arrangement of collecting venules (59%), atrophy (45%), and red streak (22%), which had fair accuracy rates of67%, 65%, and 73%, respectively. By contrast, the accuracy rates of nodularity (89%) and mucosal swelling (77%) were highest. The 20endoscopists who more frequently identified these findings diagnosed H. pylori infection significantly more accurately than did the otherendoscopists (71% vs. 64%, p=0.008). Conclusions: Careful attention to nodularity and mucosal swelling in patients with mild atrophy may enhance diagnosis, enable prompttreatment, and avoid possible long-term carcinogenesis.
Abstract
Background/Aims: This study examined the accuracy of endoscopic evaluation for determining the Helicobacter pylori infection statusin patients with mild atrophy who might not exhibit characteristic endoscopic findings. Methods: Forty endoscopists determined the H. pylori infection status of 50 randomly presented H. pylori-positive and H. pylorinegativecases on the basis of a list of established findings. Results: The median clinical endoscopy experience was 7 years (range, 1–35 years), including 22 board-certified endoscopists (55%) of theJapan Gastroenterological Endoscopy Society. The mean accuracy rate of endoscopic diagnosis was 67% and was unrelated to experiencestatus (experienced vs. trainee: 69% vs. 65%, p=0.089) and total years of experience (R2=0.022). The most frequently selected endoscopicfindings were regular arrangement of collecting venules (59%), atrophy (45%), and red streak (22%), which had fair accuracy rates of67%, 65%, and 73%, respectively. By contrast, the accuracy rates of nodularity (89%) and mucosal swelling (77%) were highest. The 20endoscopists who more frequently identified these findings diagnosed H. pylori infection significantly more accurately than did the otherendoscopists (71% vs. 64%, p=0.008). Conclusions: Careful attention to nodularity and mucosal swelling in patients with mild atrophy may enhance diagnosis, enable prompttreatment, and avoid possible long-term carcinogenesis.
참고문헌 (18)
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