Application observation of newly added Helicobacter pylori related endoscopic features in Kyoto gastritis under white light and magnifying endoscopy

doi:10.3877/cma.j.issn.2095-2015.2025.03.011

Abstract

Abstract:

Objective

To explore the application value of newly added Helicobacter pylori (Hp)related endoscopic signs in Kyoto gastritis under white light and magnifying endoscopy in Hp infection.

Methods

A total of 200 patients with Kyoto gastritis and Hp infection who underwent white light and magnifying endoscopy examination, as well as ¹⁴C/¹³C breath test or histopathological examination, at the First People's Hospital of Neijiang City from April 2024 to December 2024 were selected as the study subjects.The detection rate of Hp in patients was compared.Based on the presentation of the patient's gastric mucosa, the regular arrangement of collecting venules (RAC), gastric fundus gland polyps, ridge like redness, protruding erosions, intestinal metaplasia, atrophy, fold widening, chicken skin like changes,diffuse redness, map like redness, multiple white flat elevations, scratch sign, barnacle sign, and gastric body erosion were recorded, and the diagnostic value of Hp infection in Kyoto gastritis was compared.The diagnostic efficacy of different mucosal manifestations was compared using receiver operating characteristic(ROC) curves.

Results

Among the 200 study subjects, 121 were found to be HP positive and 79 were HP negative based on ¹⁴C/¹³C breath test or histopathological examination results.In the mucosal manifestations under white light and magnifying endoscopy, the absence of atrophy and intestinal metaplasia, presence of RAC, gastric fundus gland polyps, ridge like redness, multiple white flat elevations, map like redness, barnacles sign, and scratch sign were independent predictive factors for Hp negativity (P<0.05).Endoscopic fold enlargement, chicken skin like changes, and diffuse redness were independent predictive factors for Hp positivity (P<0.05).The patient's protruding erosion and gastric erosion had no effect on predicting Hp infection (P>0.05).

Conclusion

The newly added Hp related endoscopic features in Kyoto gastritis under white light and magnifying endoscopy have diagnostic basis for Hp infection and have certain auxiliary significance in determining Hp infection.

Key words: Magnifying endoscopy, White light endoscope, Classification of Kyoto gastritis, Endoscopic mucosal manifestations, Helicobacter pylori

Li Yang, Peiling Tang, Delan Luo, Feng Zhang, Yan Lan, Anqin Tong, Yuquan Zhong. Application observation of newly added Helicobacter pylori related endoscopic features in Kyoto gastritis under white light and magnifying endoscopy[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(03): 245-249.

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References 25

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胃镜表现	Hp 阳性(n=121)	Hp 阴性(n=79)	χ ²值	P值	OR	95% CI
RAC			121.519	＜0.001	81.778	30.239～221.158
无	115(95.04)	15(18.99)
有	6(4.96)	64(81.01)
胃底腺息肉			44.845	＜0.001	34.510	7.931～150.164
无	119(98.35)	50(63.29)
有	2(1.65)	29(36.71)
脊状发红			16.225	＜0.001	21.493	2.734～168.930
无	120(99.17)	67(84.81)
有	1(0.83)	12(15.19)
隆起性糜烂			0.050	0.823	1.096	0.491～2.439
无	104(85.95)	67(84.81)
有	17(14.05)	12(15.19)
肠化生			9.240	0.002	0.337	0.164～0.92
无	79(65.29)	12(15.19)
有	42(34.71)	67(84.81)
萎缩			13.639	＜0.001	0.272	0.133～0.556
无	73(60.33)	67(84.81)
有	48(39.67)	12(15.19)
皱襞增宽			26.745	＜0.001	0.000	0.000～
无	87(71.90)	79(100.00)
有	34(28.10)	0(0.00)
鸡皮样			5.441	0.020	0.000	0.000～
无	113(93.39)	79(100.00)
有	8(6.61)	0(0.00)
弥漫性发红			166.191	＜0.001	0.000	0.000～
无	9(7.44)	79(100.00)
有	112(92.56)	0(0.00)
地图样发红			5.008	0.025	3.362	1.104～10.244
无	116(95.87)	69(87.34)
有	5(4.13)	10(12.66)
多发性白色扁平隆起			4.007	0.045	4.432	1.138～17.253
无	118(97.52)	71(89.87)
有	3(2.48)	8(10.13)
划痕征			17.562	＜0.001	9.989	2.804～35.588
无	118(97.52)	63(79.75)
有	3(2.48)	16(20.25)
藤壶征			5.008	0.025	3.362	1.104～10.244
无	116(95.87)	69(87.34)
有	5(4.13)	10(12.66)
胃体糜烂			1.299	0.254	1.835	0.638～5.279
无	114(94.21)	71(89.87)
有	7(5.79)	8(10.13)

胃镜表现	Hp 阳性(n=121)	Hp 阴性(n=79)	χ ²值	P值	OR	95% CI
RAC			121.519	＜0.001	81.778	30.239～221.158
无	115(95.04)	15(18.99)
有	6(4.96)	64(81.01)
胃底腺息肉			44.845	＜0.001	34.510	7.931～150.164
无	119(98.35)	50(63.29)
有	2(1.65)	29(36.71)
脊状发红			16.225	＜0.001	21.493	2.734～168.930
无	120(99.17)	67(84.81)
有	1(0.83)	12(15.19)
隆起性糜烂			0.050	0.823	1.096	0.491～2.439
无	104(85.95)	67(84.81)
有	17(14.05)	12(15.19)
肠化生			9.240	0.002	0.337	0.164～0.92
无	79(65.29)	12(15.19)
有	42(34.71)	67(84.81)
萎缩			13.639	＜0.001	0.272	0.133～0.556
无	73(60.33)	67(84.81)
有	48(39.67)	12(15.19)
皱襞增宽			26.745	＜0.001	0.000	0.000～
无	87(71.90)	79(100.00)
有	34(28.10)	0(0.00)
鸡皮样			5.441	0.020	0.000	0.000～
无	113(93.39)	79(100.00)
有	8(6.61)	0(0.00)
弥漫性发红			166.191	＜0.001	0.000	0.000～
无	9(7.44)	79(100.00)
有	112(92.56)	0(0.00)
地图样发红			5.008	0.025	3.362	1.104～10.244
无	116(95.87)	69(87.34)
有	5(4.13)	10(12.66)
多发性白色扁平隆起			4.007	0.045	4.432	1.138～17.253
无	118(97.52)	71(89.87)
有	3(2.48)	8(10.13)
划痕征			17.562	＜0.001	9.989	2.804～35.588
无	118(97.52)	63(79.75)
有	3(2.48)	16(20.25)
藤壶征			5.008	0.025	3.362	1.104～10.244
无	116(95.87)	69(87.34)
有	5(4.13)	10(12.66)
胃体糜烂			1.299	0.254	1.835	0.638～5.279
无	114(94.21)	71(89.87)
有	7(5.79)	8(10.13)

胃镜表现	AUC	灵敏度	特异度	阳性预测价值	阴性预测价值
RAC	0.120	0.050	0.190	0.086	0.115
胃底腺息肉	0.325	0.017	0.633	0.065	0.296
脊状发红	0.428	0.008	0.848	0.077	0.358
隆起性糜烂	0.494	0.140	0.848	0.586	0.392
肠化生	0.598	0.347	0.152	0.385	0.132
萎缩	0.622	0.397	0.848	0.800	0.479
皱襞增宽	0.640	0.281	1.000	1.000	0.476
鸡皮样改变	0.533	0.066	1.000	1.000	0.411
弥漫性发红	0.963	0.926	1.000	1.000	0.898
地图样发红	0.457	0.041	0.873	0.333	0.373
多发性白色扁平隆起	0.462	0.025	0.899	0.273	0.376
划痕征	0.411	0.025	0.797	0.158	0.348
藤壶征	0.457	0.041	0.873	0.333	0.373

胃镜表现	AUC	灵敏度	特异度	阳性预测价值	阴性预测价值
RAC	0.120	0.050	0.190	0.086	0.115
胃底腺息肉	0.325	0.017	0.633	0.065	0.296
脊状发红	0.428	0.008	0.848	0.077	0.358
隆起性糜烂	0.494	0.140	0.848	0.586	0.392
肠化生	0.598	0.347	0.152	0.385	0.132
萎缩	0.622	0.397	0.848	0.800	0.479
皱襞增宽	0.640	0.281	1.000	1.000	0.476
鸡皮样改变	0.533	0.066	1.000	1.000	0.411
弥漫性发红	0.963	0.926	1.000	1.000	0.898
地图样发红	0.457	0.041	0.873	0.333	0.373
多发性白色扁平隆起	0.462	0.025	0.899	0.273	0.376
划痕征	0.411	0.025	0.797	0.158	0.348
藤壶征	0.457	0.041	0.873	0.333	0.373

胃镜表现	未感染(N=59)	除菌后(N=20)	χ ²值	P值	OR	95% CI
划痕征			3.995	0.002	8.041	1.831～35.313
无	45(76.27)	18(90.00)
有	14(23.73)	2(10.00)
藤壶征			22.658	0.001	5.082	3.857～6.696
无	59(100.00)	10(50.00)
有	0(0.00)	10(50.00)
胃体糜烂			3.273	0.070	7.31	2.725～20.813
无	55(93.22)	16(80.00)
有	4(6.78)	4(20.00)

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