Predicting Helicobacter pylori infection from endoscopic features
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and 13C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.
Abstract
Background: Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. Methods: A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and 13C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. Results: The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Conclusions: Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.
참고문헌 (26)
- Malfertheiner P, "Management of Helicobacter pylori infection--the Maastricht IV", Florence Consensus Report, 2012, pp.61, 646~664
- Hooi JKY, "Global prevalence of Helicobacter pylori infection : systematic review and meta-analysis", Gastroenterology, 153, pp.420~429 (2017)
- Uemura N, "Helicobacter pylori infection and the development of gastric cancer", N Engl J Med, 345, pp.784~789 (2001)
- Graham DY, "Helicobacter pylori infection in the pathogenesis of duodenal ulcer and gastric cancer : a model", Gastroenterology, 113, pp.1983~1991 (1997)
- Kamada T, "Clinical features of gastric cancer discovered after successful eradication of Helicobacter pylori : results from a 9-year prospective follow-up study in Japan", Aliment Pharmacol Ther, 21, pp.1121~1126 (2005)
- Fukase K, "Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer : an open-label, randomised controlled trial", Lancet, 372, pp.392~397 (2008)
- Haruma K, "Kyoto classification of gastritis" (2017), Nihon Medical Center
- Kim DB, "Accuracy of endoscopic diagnosis of mild atrophic gastritis with Helicobacter pylori infection", Clin Endosc, 51, pp.310~312 (2018)
- Alaboudy A, "Regular arrangement of collecting venules : does patient age affect its accuracy?", World J Gastrointest Endosc, 3, pp.118~123 (2011)
- Garcés-Durán R, "Association between a regular arrangement of collecting venules and absence of Helicobacter pylori infection in a European population", Gastrointest Endosc, 90, pp.461~466 (2019)
- Watanabe K, "Accuracy of endoscopic diagnosis of Helicobacter pylori infection according to level of endoscopic experience and the effect of training", BMC Gastroenterol, 13, pp.128~ (2013)
- Garcés-Durán R, "Diagnosis of Helicobacter pylori infection by the arrangement of collecting venules using white light endoscopy : evaluation of interobserver agreement", Dig Dis, 40, pp.376~384 (2022)
- Chen MJ, "Nodular gastritis : an endoscopic indicator of Helicobacter pylori infection", Dig Dis Sci, 52, pp.2662~2666 (2007)
- Kim OZ, "Prediction of Helicobacter pylori infection by endoscopic severity of erythematous", exudative gastritis in asymptomatic adults, 2022, pp.80, 135~141
- Hojo M, "Endoscopic findings of Helicobacter pylori gastritis in children and young adults based on the Kyoto classification of gastritis and age-associated changes", JGH Open, 5, pp.1197~1202 (2021)
- Yuan C, "Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy", BMC Gastroenterol, 21, pp.389~ (2021)
- Appelman HD, "Gastritis : terminology, etiology, and clinicopathological correlations : another biased view", Hum Pathol, 25, pp.1006~1019 (1994)
- Kaiserling E, "Lipid islands in human gastric mucosa : morphological and immunohistochemical findings", Gastroenterology, 110, pp.369~374 (1996)
- Kitamura S, "Clinicopathological assessment of gastric xanthoma as potential predictive marker of gastric cancer", Digestion, 96, pp.199~206 (2017)
- Isomoto H, "A close relationship between Helicobacter pylori infection and gastric xanthoma", Scand J Gastroenterol, 34, pp.346~352 (1999)
- Yi SY, "Dyslipidemia and H pylori in gastric xanthomatosis", World J Gastroenterol, 13, pp.4598~4601 (2007)
- Toyoshima O, "Helicobacter pylori infection in subjects negative for high titer serum antibody", World J Gastroenterol, 24, pp.1419~1428 (2018)
- Kishikawa H, "Previous Helicobacter pylori infection-induced atrophic gastritis : a distinct disease entity in an understudied population without a history of eradication", Helicobacter, 25, pp.e12669~ (2020)
- Kato T, "Diagnosis of Helicobacter pylori infection in gastric mucosa by endoscopic features : a multicenter prospective study", Dig Endosc, 25, pp.508~518 (2013)
- Li P, "Mucus penetration enhanced lipid polymer nanoparticles improve the eradication rate of Helicobacter pylori biofilm", J Control Release, 300, pp.52~63 (2019)
- Ensign LM, "Oral drug delivery with polymeric nanoparticles : the gastrointestinal mucus barriers", Adv Drug Deliv Rev, 64, pp.557~570 (2012)