Cho JH, Jeon SR, Jin SY, Park S. Standard vs magnifying narrow-band imaging endoscopy for diagnosis of Helicobacter pylori infection and gastric precancerous conditions. World J Gastroenterol 2021; 27(18): 2238-2250 [PMID: 34025076 DOI: 10.3748/wjg.v27.i18.2238]
Corresponding Author of This Article
Jun-Hyung Cho, MD, PhD, Associate Professor, Digestive Disease Center, Soonchunhyang University Hospital, No. 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, South Korea. chojhmd@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Gastroenterol. May 14, 2021; 27(18): 2238-2250 Published online May 14, 2021. doi: 10.3748/wjg.v27.i18.2238
Table 1 Baseline characteristics of the study population
Characteristic
n = 254
Age (yr, mean ± SD)
45.9 ± 14.6
Sex, male, n (%)
119 (46.9)
Indication for endoscopy, n (%)
Screening
132 (52.0)
Dyspepsia
42 (16.5)
Abdominal pain
47 (18.5)
Other
33 (13.0)
Endoscopic diagnosis, n (%)
Peptic ulcer
11 (4.3)
Gastric neoplasia
25 (9.8)
Non-neoplastic polyp
19 (7.5)
Chronic active gastritis
135 (53.1)
Helicobacter pylori infection, n (%)
163 (64.2)
Gastric atrophy, n (%)
None/mild
117 (66.9)
Moderate
37 (21.1)
Severe
21 (12.0)
Intestinal metaplasia, n (%)
None
115 (65.7)
Antrum only
22 (12.6)
Corpus
38 (21.7)
Serum PG (ng/mL, mean ± SD)
PG I
64.4 ± 32.4
PG II
20.5 ± 14.7
PG I/II ratio
4.11 ± 2.2
Serum gastrin (pg/mL, mean ± SD)
123.1 ± 149.9
Table 2Helicobacter pylori gastritis, gastric atrophy, and intestinal metaplasia observed by standard and magnifying narrow-band imaging endoscopy
Endoscopy
H. pylori gastritis
Gastric atrophy
Intestinal metaplasia
Negative
Positive
None/mild
Moderate/severe
None/antrum
Corpus
(n = 91)
(n = 163)
(n = 117)
(n = 58)
(n = 137)
(n = 38)
Standard
Normal
87/100 (87.0)
13/100 (13.0)
70/72 (97.2)
2/72 (2.8)
71/72 (98.6)
1/72 (1.4)
Type A
4/47 (8.5)
43/47 (91.5)
24/33 (72.7)
9/33 (27.3)
25/33 (75.8)
8/33 (24.2)
Type B
0/84 (0)
84/84 (100)
13/50 (26.0)
37/50 (74.0)
24/50 (48.0)
26/50 (52.0)
Type C
0/23 (0)
23/23 (100)
10/20 (50.0)
10/20 (50.0)
17/20 (85.0)
3/20 (15.0)
M-NBI
Normal
87/93 (93.5)
6/93 (6.5)
69/69 (100)
0/69 (0)
69/69 (100)
0/69 (0)
Type Z-1
3/127 (2.4)
124/127 (97.6)
46/85 (54.1)
39/85 (45.9)
59/85 (69.4)
26/85 (30.6)
Type Z-2
1/27 (3.7)
26/27 (96.3)
2/17 (11.8)
15/17 (88.2)
7/17 (41.2)
10/17 (58.8)
Type Z-3
0/7 (0)
7/7 (100)
0/4 (0)
4/4 (100)
2/4 (50.0)
2/4 (50.0)
Table 3 Diagnostic performance of standard and magnifying narrow-band imaging endoscopy for Helicobacter pylori gastritis, gastric atrophy, and intestinal metaplasia
Table 4 Serum pepsinogen I/II ratio according to gastric mucosal pattern observed by standard and magnifying narrow-band imaging endoscopy
PG I/II ratio
Standard (%)
M-NBI (%)
Normal
Type A
Type B
Type C
Normal
Type Z-1
Type Z-2
Type Z-3
> 3 (n = 71)
38/39 (97.4)
16/25 (64.0)
13/46 (28.3)
4/17 (23.5)
36/36 (100)
33/72 (45.8)
2/15 (13.3)
0/4 (0)
≤ 3 (n = 56)
1/39 (2.6)
9/25 (36.0)
33/46 (71.7)
13/17 (76.5)
0/36 (0)
39/72 (54.2)
13/15 (86.7)
4/4 (100)
Table 5 Logistic regression analysis of the associations of endoscopic mucosal patterns with gastric precancerous conditions
Mucosal pattern
Moderate to severe atrophy
Intestinal metaplasia, corpus
PG I/II ratio ≤ 3
OR (95%CI)
P value
OR (95%CI)
P value
OR (95%CI)
P value
Standard
0.001
0.189
0.004
Type A
1 (ref.)
1 (ref.)
1 (ref.)
Type B + C
5.56 (2.07-14.92)
1.96 (0.72-5.33)
4.48 (1.60-12.54)
M-NBI
0.007
0.162
0.029
Type Z-1
1 (ref.)
1 (ref.)
1 (ref.)
Type Z-2 + Z-3
8.67 (1.82-41.30)
2.12 (0.74-6.07)
5.69 (1.19-27.18)
Citation: Cho JH, Jeon SR, Jin SY, Park S. Standard vs magnifying narrow-band imaging endoscopy for diagnosis of Helicobacter pylori infection and gastric precancerous conditions. World J Gastroenterol 2021; 27(18): 2238-2250