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Adachi K, Ebisutani Y, Matsubara Y, Okimoto E, Ishimura N, Ishihara S. Effectiveness of Artificial Intelligence in Screening Esophagogastroduodenoscopy. Cureus 2025; 17:e79935. [PMID: 40177429 PMCID: PMC11962169 DOI: 10.7759/cureus.79935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2025] [Indexed: 04/05/2025] Open
Abstract
BACKGROUND This retrospective study investigated the usefulness of the EW10-EG01 artificial intelligence (AI) application for screening esophagogastroduodenoscopy (EGD). METHODOLOGY A total of 7,655 subjects (4,863 men, 2,792 women; mean age 54.9±10.1 years) who underwent EGD during a medical checkup were enrolled in the study. The number of diagnosed upper gastrointestinal tumors was compared between EGD examinations performed with and without the AI system. RESULTS EGD examinations with and without the AI system were performed on 3,841 and 3,814 subjects, respectively. Biopsy procedures were more frequently performed, and examination time was longer in EGD with AI applications than in those without. Upper gastrointestinal tumors diagnosed by EGD with and without AI were 39 (1.02%) and 24 (0.63%), respectively (P = 0.062). There was a significant difference in the detection rate of esophageal and gastric tumors between EGD with (30, 0.78%) and without (14, 0.37%) the AI system (P = 0.017). When endoscopists were divided into three groups based on their experience with the EW10-EG01 application, higher detection rates of esophageal and gastric tumors were observed in each group when using EGD with AI. CONCLUSIONS Usage of the EW10-EG01 AI system may be useful for screening EGD due to the increased esophageal and gastric tumor detection rate.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Yuri Ebisutani
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Yuko Matsubara
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Eiko Okimoto
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo, JPN
| | - Shunji Ishihara
- Second Department of Internal Medicine, Faculty of Medicine, Shimane University, Izumo, JPN
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Zou PY, Zhu JR, Zhao Z, Mei H, Zhao JT, Sun WJ, Wang GH, Chen DF, Fan LL, Lan CH. Development and application of an artificial intelligence-assisted endoscopy system for diagnosis of Helicobacter pylori infection: a multicenter randomized controlled study. BMC Gastroenterol 2024; 24:335. [PMID: 39350033 PMCID: PMC11440712 DOI: 10.1186/s12876-024-03389-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 08/27/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The early diagnosis and treatment of Heliobacter pylori (H.pylori) gastrointestinal infection provide significant benefits to patients. We constructed a convolutional neural network (CNN) model based on an endoscopic system to diagnose H. pylori infection, and then examined the potential benefit of this model to endoscopists in their diagnosis of H. pylori infection. MATERIALS AND METHODS A CNN neural network system for endoscopic diagnosis of H.pylori infection was established by collecting 7377 endoscopic images from 639 patients. The accuracy, sensitivity, and specificity were determined. Then, a randomized controlled study was used to compare the accuracy of diagnosis of H. pylori infection by endoscopists who were assisted or unassisted by this CNN model. RESULTS The deep CNN model for diagnosis of H. pylori infection had an accuracy of 89.6%, a sensitivity of 90.9%, and a specificity of 88.9%. Relative to the group of endoscopists unassisted by AI, the AI-assisted group had better accuracy (92.8% [194/209; 95%CI: 89.3%, 96.4%] vs. 75.6% [158/209; 95%CI: 69.7%, 81.5%]), sensitivity (91.8% [67/73; 95%CI: 85.3%, 98.2%] vs. 78.6% [44/56; 95%CI: 67.5%, 89.7%]), and specificity (93.4% [127/136; 95%CI: 89.2%, 97.6%] vs. 74.5% [114/153; 95%CI: 67.5%, 81.5%]). All of these differences were statistically significant (P < 0.05). CONCLUSION Our AI-assisted system for diagnosis of H. pylori infection has significant ability for diagnostic, and can improve the accuracy of endoscopists in gastroscopic diagnosis. TRIAL REGISTRATION This study was approved by the Ethics Committee of Daping Hospital (10/07/2020) (No.89,2020) and was registered with the Chinese Clinical Trial Registration Center (02/09/2020) ( www.chictr.org.cn ; registration number: ChiCTR2000037801).
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Affiliation(s)
- Pei-Ying Zou
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Jian-Ru Zhu
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Zhe Zhao
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Hao Mei
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Jing-Tao Zhao
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Wen-Jing Sun
- Chongqing 13, People's Hospital, Chongqing, China
| | | | - Dong-Feng Chen
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China
| | - Li-Lin Fan
- Chongqing Jiulongpo District Second People's Hospital, Chongqing, China
| | - Chun-Hui Lan
- Department of Gastroenterology, Chongqing Key Laboratory of Digestive, Malignancies, Daping Hospital, Army Medical University, Third Military Medical University), 10 Changjiang Branch Road, Chongqing, 400000, China.
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Okimoto E, Adachi K, Ebisutani Y, Ishimura N, Ishihara S. Prevalence of Gastric Epithelial Tumors in Helicobacter pylori-uninfected Individuals Undergoing a Medical Checkup. Intern Med 2024; 63:2251-2258. [PMID: 38220193 DOI: 10.2169/internalmedicine.2955-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Objective This study investigated the prevalence of gastric epithelial tumor in Helicobacter pylori-uninfected subjects who underwent esophagogastroduodenoscopy (EGD) as part of an annual checkup. Methods A total of 20,540 EGD examinations of H. pylori-uninfected individuals (12,917 men, 7,623 women; mean age 51.5±9.2 years old) were performed between April 2016 and March 2023. The prevalence of gastric epithelial tumor discovery and the size and location of each lesion type were analyzed. Results According to 20,540 examinations, 61 gastric epithelial tumors were endoscopically and histologically diagnosed in 58 of the subjects, with a prevalence rate of 0.28%. These tumors included signet-ring carcinoma (n=10, 0.05%), gastric adenocarcinoma of fundic-gland type (n=10, 0.05%), intestinal-type well-differentiated adenocarcinoma (n=2, 0.01%), and raspberry-type gastric foveolar tumors (n=36, 0.18%). One subject had two intestinal-type well-differentiated adenocarcinomas, and two each had two raspberry-type gastric foveolar tumors. The mean sizes of the signet-ring carcinomas, gastric adenocarcinoma of fundic-gland type, intestinal-type well-differentiated adenocarcinomas, and raspberry-type gastric foveolar tumors were 6.4, 4.7, 5.0, and 3.4 mm, respectively. Each lesion was located at a specific site in the stomach characteristic of its type. Conclusion In the present H. pylori-uninfected subjects, the prevalence of gastric epithelial tumors found on an EGD examination was 0.28%. Endoscopic examination should be performed in H. pylori-uninfected individuals to detect such tumors in characteristic locations.
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Affiliation(s)
- Eiko Okimoto
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Yuri Ebisutani
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Gao C, Zhang G, Zheng J, Zheng Y, Lin W, Xu G, You Y, Li D, Wang W. The value of LCI-based modified Kyoto classification risk scoring system in predicting the risk of early gastric cancer. Scand J Gastroenterol 2024; 59:859-867. [PMID: 38578144 DOI: 10.1080/00365521.2024.2338443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/21/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To study and compare the value of the Kyoto classification risk scoring system and the modified Kyoto classification risk scoring system based on linked color imaging (LCI) in predicting the risk of early gastric cancer. METHODS One hundred and fifty patients with pathologically confirmed non-cardia early gastric cancer by endoscopic LCI and 150 non-gastric cancer patients matched for age and gender were included. Basic patient data and whole gastric endoscopic images under LCI were collected, and the images were scored according to the LCI-based Kyoto classification risk scoring system and the LCI-based modified Kyoto classification risk scoring system. RESULTS Compared with the LCI-based Kyoto classification risk scoring system, the LCI-based modified Kyoto classification risk scoring system had a higher AUC for predicting the risk of early gastric cancer (0.723 vs. 0.784, p = 0.023), with a score of ≥3 being the best cutoff value for predicting the risk of early gastric cancer (sensitivity 61.33%, specificity 86.00%), and scores of 3 to 5 were significantly associated with early gastric carcinogenesis significantly (OR = 9.032, 95% CI: 4.995-16.330, p < 0.001). CONCLUSIONS Compared with the LCI-based Kyoto classification risk scoring system, the LCI-based Kyoto modified classification risk scoring system has a better value for predicting the risk of early gastric cancer, and the score of 3 to 5 is a high-risk factor for the risk of early gastric cancer development, which is more strongly correlated with the risk of early gastric cancer.
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Affiliation(s)
- Chao Gao
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Guanpo Zhang
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Jin Zheng
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Yunmeng Zheng
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Wulian Lin
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Guilin Xu
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Yixiang You
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Dazhou Li
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
| | - Wen Wang
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force, People's Liberation Army, Fuzhou, China
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Kato M, Ono S, Kawada K, Dohi O, Kitamura S, Koike T, Hori S, Kanzaki H, Murao T, Yagi N, Sasaki F, Hashiguchi K, Oka S, Katada K, Shimoda R, Mizukami K, Suehiro M, Takeuchi T, Katsuki S, Tsuda M, Naito Y, Kawano T, Haruma K, Mori K, Ishikawa H. Diagnostic performance of linked color imaging for gastric cancer by Helicobacter pylori infection status: A subanalysis of the large-scale, multicenter randomized controlled trial LCI-FIND. Helicobacter 2024; 29:e13080. [PMID: 38671594 DOI: 10.1111/hel.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Linked color imaging (LCI) is a new image enhancement technology that facilitates the recognition of subtle differences in mucosal color. In the large-scale, multicenter randomized controlled trial LCI-FIND, LCI demonstrated good diagnostic performance for the detection of tumor lesions in the upper gastrointestinal tract. The aim of the present study was to exploratively evaluate the diagnostic performance of LCI according to H. pylori infection status as a subanalysis of LCI-FIND trial. METHODS The patients were randomly allocated to receive white light imaging (WLI) first, followed by LCI (WLI group), or vice versa (LCI group), and the two groups were compared for the detection of tumors. Data from this trial were analyzed by the presence/absence of H. pylori infection and further analyzed by successful or unsuccessful eradication in the H. pylori infection group. RESULTS The 752 patients in the WLI group and 750 patients in the LCI group who had participated in the LCI-FIND trial were included. In the successful eradication group, more gastric lesions were detected by primary mode in the LCI group than in the WLI group, indicating that more lesions were missed by WLI. Fisher's exact probability test for the comparison of the WLI and LCI groups yielded a p-value of 0.0068, with missed gastric lesions being detected 0.136 times (95% confidence interval: 0.020-0.923), significantly less with LCI than with WLI. CONCLUSION The current study suggests that LCI should be used for gastric cancer screening, particularly in patients with successful H. pylori eradication.
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Affiliation(s)
- Mototsugu Kato
- Public Interest Foundation Hokkaido Cancer Society, Sapporo, Hokkaido, Japan
- Department of Gastroenterology, National Hospital organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Shoko Ono
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Kenro Kawada
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Osamu Dohi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinji Kitamura
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shinichiro Hori
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takahisa Murao
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Nobuaki Yagi
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Fumisato Sasaki
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuhiro Katada
- Department of Gastroenterology and Hepatology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Shimoda
- Department of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan
| | | | - Mitsuhiko Suehiro
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Toshihisa Takeuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinichi Katsuki
- Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Hokkaido, Japan
| | - Momoko Tsuda
- Public Interest Foundation Hokkaido Cancer Society, Sapporo, Hokkaido, Japan
- Department of Gastroenterology, National Hospital organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Yuji Naito
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Keita Mori
- Clinical Research Promotion Unit, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Osaka, Japan
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Fujita T, Umegaki E, Masuda A, Kobayashi M, Yamazaki Y, Terao S, Sanuki T, Okada A, Murakami M, Watanabe A, Obata D, Yoshinaka H, Kutsumi H, Azuma T, Kodama Y. Factors Associated with Overlap between Functional Dyspepsia and Nonerosive Reflux Disease in Endoscopy-based Helicobacter pylori-uninfected Japanese Health Checkup Participants: A Prospective, Multicenter Cross-sectional Study. Intern Med 2024; 63:639-647. [PMID: 37438139 PMCID: PMC10982007 DOI: 10.2169/internalmedicine.1786-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/01/2023] [Indexed: 07/14/2023] Open
Abstract
Objective We assessed the factors associated with overlap between functional dyspepsia (FD) and nonerosive reflux disease (NERD) in endoscopy-based Helicobacter pylori-uninfected Japanese health checkup participants. Methods We utilized baseline data from 3,085 individuals who underwent upper endoscopy for health screening in a prospective, multicenter cohort study. The participants were asked to complete a questionnaire detailing their upper abdominal symptoms and lifestyle. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) score. FD, postprandial distress syndrome (PDS), and epigastric pain syndrome (EPS) were defined according to the Rome III criteria. NERD was defined as heartburn or regurgitation ≥1 day/week without erosive esophagitis. Results Of the 3,085 participants, 73 (2.4%), 97 (3.1%), and 84 (2.7%) had FD alone, NERD alone, and FD-NERD overlap, respectively. Factors associated with FD-NERD-overlap participants compared with participants with neither FD nor NERD were women [odds ratio (OR): 2.08, 95% confidence interval (CI): 1.24-3.52], body mass index (BMI) <18.5 (OR: 2.87, 95% CI: 1.56-5.07), alcohol consumption ≥20 g/day (OR: 1.85, 95% CI: 1.06-3.15), and a high STAI score (OR: 2.53, 95% CI: 1.62-4.00). Increasing age (OR: 1.06, 95% CI: 1.01-1.11) and EPS symptoms [pure EPS (OR: 3.67, 95% CI: 1.65-8.51) and PDS-EPS overlap (OR: 11.6, 95% CI: 4.09-37.2)] were associated with FD-NERD overlap vs. FD alone. Women (OR: 3.17, 95% CI: 1.47-7.04), BMI <18.5 (OR: 3.03, 95% CI: 1.04-9.90), and acid reflux symptoms ≥2 days a week (OR: 3.57, 95% CI: 1.83-7.14) were associated with FD-NERD overlap vs. NERD alone. Conclusion Understanding the clinical features of overlap between FD and NERD will lead to better management.
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Affiliation(s)
- Tsuyoshi Fujita
- Department of Health Care, Yodogawa Christian Hospital, Japan
| | - Eiji Umegaki
- Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Japan
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Atsuhiro Masuda
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Masao Kobayashi
- Department of Health Care, Kyoto Second Red Cross Hospital, Japan
| | | | - Shuichi Terao
- Department of Gastroenterology, Kakogawa Central City Hospital, Japan
| | - Tsuyoshi Sanuki
- Department of Gastroenterology, Kita-harima Medical Center, Japan
| | - Akihiko Okada
- Department of Gastroenterology, Saiseikai Nakatsu Hospital, Japan
| | - Manabu Murakami
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Akihiko Watanabe
- Department of Gastroenterology, Yodogawa Christian Hospital, Japan
| | - Daisuke Obata
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
- Center for Clinical Research and Advanced Medicine, Shiga University Medical Science, Japan
| | - Hayato Yoshinaka
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
- Center for Clinical Research and Advanced Medicine, Shiga University Medical Science, Japan
| | - Hiromu Kutsumi
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
- Center for Clinical Research and Advanced Medicine, Shiga University Medical Science, Japan
| | - Takeshi Azuma
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Yuzo Kodama
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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Korzheva I, Laktyun’kina E, Kozyr’ L, Fomina M. The role of the Kyoto classification in the endoscopic diagnosis of gastritis associated with Helicobacter pylori infection. ENDOSCOPIC SURGERY 2024; 30:65. [DOI: 10.17116/endoskop20243004165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
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Zhang Y, Wang JZ, Bai X, Zhang PL, Guo Q. Clinical usefulness of linked color imaging in identifying Helicobacter pylori infection: A systematic review and meta-analysis. World J Gastrointest Endosc 2023; 15:735-744. [PMID: 38187911 PMCID: PMC10768039 DOI: 10.4253/wjge.v15.i12.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 12/15/2023] Open
Abstract
BACKGROUND Accurate diagnosis of Helicobacter pylori (H. pylori) infection status is a crucial premise for eradication therapy, as well as evaluation of risk for gastric cancer. Recent progress on imaging enhancement endoscopy (IEE) made it possible to not only detect precancerous lesions and early gastrointestinal cancers but also to predict H. pylori infection in real time. As a novel IEE modality, linked color imaging (LCI) has exhibited its value on diagnosis of lesions of gastric mucosa through emphasizing minor differences of color tone.
AIM To compare the efficacy of LCI for H. pylori active infection vs conventional white light imaging (WLI).
METHODS PubMed, Embase, Embase and Cochrane Library were searched up to the end of April 11, 2022. The random-effects model was adopted to calculate the diagnostic efficacy of LCI and WLI. The calculation of sensitivity, specificity, and likelihood ratios were performed; symmetric receiver operator characteristic (SROC) curves and the areas under the SROC curves were computed. Quality of the included studies was chosen to assess using the quality assessment of diagnostic accuracy studies-2 tool.
RESULTS Seven original studies were included in this study. The pooled sensitivity, specificity, positive likelihood rate, and negative likelihood rate of LCI for the diagnosis of H. pylori infection of gastric mucosa were 0.85 [95% confidence interval (CI): 0.76-0.92], 0.82 (95%CI: 0.78-0.85), 4.71 (95%CI: 3.7-5.9), and 0.18 (95%CI: 0.10-0.31) respectively, with diagnostic odds ratio = 26 (95%CI: 13-52), SROC = 0.87 (95%CI: 0.84-0.90), which showed superiority of diagnostic efficacy compared to WLI.
CONCLUSION Our results showed LCI can improve efficacy of diagnosis on H. pylori infection, which represents a useful endoscopic evaluation modality for clinical practice.
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Affiliation(s)
- Yu Zhang
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
- Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
| | - Jing-Zhai Wang
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
- Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
| | - Xuan Bai
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
- Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
| | - Peng-Li Zhang
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
- Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
| | - Qiang Guo
- Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
- Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
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Liu X, Wang X, Mao T, Yin X, Wei Z, Fu J, Wu J, Li X. Characteristic analysis of early gastric cancer after Helicobacter pylori eradication: a multicenter retrospective propensity score-matched study. Ann Med 2023; 55:2231852. [PMID: 37450336 PMCID: PMC10351464 DOI: 10.1080/07853890.2023.2231852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is recognized as a type I carcinogen in gastric cancer (GC). However, GC still occurs after H. pylori eradication, and its diagnosis is more complicated. This study aimed to summarize the characteristics of early GC (EGC) after H. pylori eradication to help accurately identify EGC and avoid missed diagnosis and misdiagnosis. METHODS A total of 81 patients of EGC after H. pylori eradication (Hp-eradicated group), resected by endoscopic submucosal dissection (ESD), and 105 cases of H. pylori infection-related EGC (control group) were assessed. After propensity-score matching, the clinical characteristics, endoscopic manifestations, and histopathological features of the 62 matched patients in each group were analyzed. We also conducted specific analyses in combination with endoscopic and histopathological images. RESULTS There were more patients in the Hp-eradicated group who received proton pump inhibitor (PPI) for >1 year compared to the control group (p < 0.001). More patients at OLGA stages I-II before the diagnosis of EGC were in the control group (p = 0.045), especially at stage II. The mucosa in the Hp-eradicated group showed more moderate-to-severe atrophy (p = 0.047), map-like redness (p < 0.001) and mild activity (p < 0.001). The predominant histopathological types differed between the two groups (p < 0.001), and the majority of cases in the Hp-eradicated group were high-grade intraepithelial neoplasia (HGIN). Ki-67 expression was lower in the Hp-eradicated group (p = 0.025). But different eradication intervals of H. pylori have little effect on the characteristics of EGC. Furthermore, PPI uses for >1 year (p = 0.005), mucosal map-like redness (p < 0.001), moderate mucosal atrophy (p = 0.017), and mild activity of gastric mucosa (p = 0.005) were independent characteristics of EGC after H. pylori eradication. CONCLUSION Our multicenter study revealed that EGC after H. pylori eradication was characterized by long-term PPI use, moderate mucosal atrophy, mucosal map-like redness, the mild activity of gastric mucosa, a higher proportion of HGIN cases, and lower levels of Ki-67.
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Affiliation(s)
- Xinyuan Liu
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Xinyu Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Tao Mao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Xiaoyan Yin
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Zhi Wei
- Department of Gastroenterology, Shandong Second Provinical General Hospital, Jinan, P.R. China
| | - Jindong Fu
- Department of Gastroenterology, People’s Hospital of Rizhao, Rizhao, P.R. China
| | - Jie Wu
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
| | - Xiaoyu Li
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, P.R. China
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10
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Kang D, Lee K, Kim J. Diagnostic usefulness of deep learning methods for Helicobacter pylori infection using esophagogastroduodenoscopy images. JGH Open 2023; 7:875-883. [PMID: 38162866 PMCID: PMC10757494 DOI: 10.1002/jgh3.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/02/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
Background and Aims We aimed to assess the diagnostic potential of deep convolutional neural networks (DCNNs) for detecting Helicobacter pylori infection in patients who underwent esophagogastroduodenoscopy and Campylobacter-like organism tests. Methods We categorized a total of 13,071 images of various gastric sub-areas and employed five pretrained DCNN architectures: ResNet-101, Xception, Inception-v3, InceptionResnet-v2, and DenseNet-201. Additionally, we created an ensemble model by combining the output probabilities of the best models. We used images of different sub-areas of the stomach for training and evaluated the performance of our models. The diagnostic metrics assessed included area under the curve (AUC), specificity, accuracy, positive predictive value, and negative predictive value. Results When training included images from all sub-areas of the stomach, our ensemble model demonstrated the highest AUC (0.867), with specificity at 78.44%, accuracy at 80.28%, positive predictive value at 82.66%, and negative predictive value at 77.37%. Significant differences were observed in AUC between the ensemble model and the individual DCNN models. When training utilized images from each sub-area separately, the AUC values for the antrum, cardia and fundus, lower body greater curvature and lesser curvature, and upper body greater curvature and lesser curvature regions were 0.842, 0.826, 0.718, and 0.858, respectively, when the ensemble model was used. Conclusions Our study demonstrates that the DCNN model, designed for automated image analysis, holds promise for the evaluation and diagnosis of Helicobacter pylori infection.
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Affiliation(s)
- Daesung Kang
- Department of Healthcare Information TechnologyInje UniversityGimhaeRepublic of Korea
| | - Kayoung Lee
- Department of Family medicine, Busan Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Jinseung Kim
- Department of Family medicine, Busan Paik HospitalInje University College of MedicineBusanRepublic of Korea
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11
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Zhang Q, Yang S, Zhou J, Li Z, Wang L, Dong Q. Diagnostic accuracy of stool sample-based PCR in detecting Helicobacter pylori infection: a meta-analysis. J LAB MED 2023; 47:187-197. [DOI: 10.1515/labmed-2023-0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2025] Open
Abstract
Abstract
The present study was to evaluate the diagnostic accuracy of different types of PCR tests with the aim of determining which one performs best for detecting Helicobacter pylori in stool samples. Related articles were searched from PubMed, Embase, Web of Science databases, Scopus, and Scholar Google. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool and RevMan5.4 software. Pooled sensitivity, specificity, DOR, PLR and NLR for the stool PCR test in detecting H. pylori infection were performed by Stata 15.0 software. Subgroup meta-analysis was performed by Open Meta-analyst software. Ten studies were selected in this study. Stool PCR test had 92.0 % (83.0, 96.0 %) pooled sensitivity, 96.0 % (84.0, 99.0 %) pooled specificity, 296.0 (51.6, 1,696.9) pooled DOR, 26.1 (5.3, 128.7) pooled PLR and 0.09 (0.04, 0.18) NLR in the diagnosis of H. pylori infection, and summary receiver operating characteristic curve (SROC) illustrated an area under the curve (AUC) of 0.98. Subgroup meta-analysis showed rtPCR as having the highest diagnostic accuracy. Our results identify rtPCR as having the highest diagnostic accuracy for the detection of H. pylori in stool samples, and the stool PCR test as a reliable diagnostic tool for H. pylori infection.
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Affiliation(s)
- Qinglong Zhang
- Central Laboratories , Qingdao Municipal Hospital , Qingdao , P.R. China
- Shandong First Medical University , Jinan , P.R. China
| | - Shuang Yang
- Fever Clinic , Qingdao Municipal Hospital , Qingdao , P.R. China
| | - Jianhua Zhou
- Department of Stomatology , Qingdao Municipal Hospital , Qingdao , P.R. China
| | - Zhipeng Li
- Qingdao University , Qingdao , P.R. China
| | - Lili Wang
- Central Laboratories , Qingdao Municipal Hospital , Qingdao , P.R. China
| | - Quanjiang Dong
- Central Laboratories , Qingdao Municipal Hospital , Qingdao , P.R. China
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12
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Sakamoto U, Adachi K, Kishi K, Okimoto E, Ishimura N, Miura H, Ishihara S. Prevalence of Raspberry-type Gastric Foveolar-type Tumor in Individuals Undergoing Medical Checkups. Intern Med 2023; 62:2775-2781. [PMID: 36823084 PMCID: PMC10602825 DOI: 10.2169/internalmedicine.1265-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/15/2023] [Indexed: 02/23/2023] Open
Abstract
Objective This study was performed to clarify the prevalence of raspberry-type gastric foveolar-type tumors, along with the time-course changes in the size and clinical course. Methods The subjects were 10,663 consecutive patients who underwent a medical checkup between April 2016 and March 2022, including an esophagogastroduodenoscopy (EGD) examination and determination of Helicobacter pylori infection status (uninfected, positive, post-eradication). The presence of characteristic reddish polypoid lesions in the stomach was investigated, and a diagnosis of raspberry-type gastric foveolar-type tumor was made based on histological findings. Results Thirty-eight cases had gastric polyps with a raspberry-like appearance on endoscopy, with 29 lesions in 28 cases endoscopically and histologically diagnosed as a raspberry-type gastric foveolar-type tumor. All of the affected subjects were determined to be H. pylori-uninfected. The prevalence of this type of lesion in all subjects was 0.26%, while that in the 6,635 H. pylori-uninfected subjects was 0.42%. An older age and the presence of a fundic gland polyp were found to be significant risk factors associated with the occurrence of the tumor. The mean size was 3.8±1.9 (range: 2-10) mm, and the location was in a fundic gland area in all affected subjects. Furthermore, examinations of previous EGD images revealed that two-thirds of the lesions had not changed in size, while follow-up EGD findings showed that lesions ≤5 mm in size had disappeared after a biopsy procedure. Conclusion The prevalence of raspberry-type gastric foveolar-type tumors was 0.42% in H. pylori-uninfected subjects. More than half of the lesions were too small to be removed by an endoscopic biopsy.
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Affiliation(s)
- Utae Sakamoto
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kanako Kishi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Eiko Okimoto
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
| | - Hiroshi Miura
- Department of Pathology, Matsue Red Cross Hospital, Japan
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13
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Yada T, Itakura Y, Watanabe R, Odaka K, Yagi T, Ikegami Y, Sekine K, Uemura N. A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status. DEN OPEN 2022; 3:e200. [PMID: 36578950 PMCID: PMC9780418 DOI: 10.1002/deo2.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Objectives During esophagogastroduodenoscopy, a red linear scrape-like appearance with white deposits sometimes appears on the gastric mucosa at the lower greater curvature of the gastric body, a finding we named the "scratch sign." We aimed to clarify the clinical significance of this new endoscopic finding in the endoscopic evaluation of the Helicobacter pylori infection status. Methods Among patients who underwent esophagogastroduodenoscopy at our hospital between October 2016 and June 2017, 437 patients were included in the study. We first examined the overall scratch sign positivity rate, and then this was compared according to the H. pylori infection status. Subsequently, other variables were compared and examined between the positive and negative scratch sign groups. Results Overall, 437 patients were included in the analysis. The scratch sign was observed in 1.4% of 71 patients with current infections, 26.9% of 290 patients with past infections, and 31.6% of 76 uninfected patients. In the multivariate analysis, H. pylori-negative, severe gastric mucosal atrophy, and acid secretion depressant were independent factors that significantly affected the appearance of the scratch sign. Conclusions A novel endoscopic finding, the scratch sign, was found to be a good endoscopic predictor of H. pylori-negative gastric mucosa. Furthermore, combined with atrophic changes and xanthomas that persisted after eradication, these findings were found to be useful in accurately diagnosing H. pylori past-infected gastric mucosa endoscopically.
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Affiliation(s)
- Tomoyuki Yada
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Yoshiyuki Itakura
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan,Division of GastroenterologyMatsue Red Cross HospitalShimaneJapan
| | - Ryo Watanabe
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Keita Odaka
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Toyokazu Yagi
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Yurika Ikegami
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Katsunori Sekine
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
| | - Naomi Uemura
- Division of Gastroenterology and HepatologyKohnodai Hospital, National Center for Global Health and MedicineChibaJapan
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14
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Xi S, Jing L, Lili W, Tingting L, Jun L, Ming W, Zhiqiang W, Peng J. Magnetic controlled capsule endoscope (MCCE)'s diagnostic performance for H. pylori infection status based on the Kyoto classification of gastritis. BMC Gastroenterol 2022; 22:502. [PMID: 36474169 PMCID: PMC9724339 DOI: 10.1186/s12876-022-02589-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have shown that the Kyoto classification of gastritis can accurately predict H. pylori infection status on conventional gastroscopy. The aim of this study was to test whether the Kyoto classification of gastritis applies well to magnetic controlled capsule endoscopy (MCCE). METHODS We consecutively recruited 227 participants who underwent both MCCE and urea breath tests (UBTs). Two physicians who were blinded to the UBT results independently made the diagnosis of H. pylori infection status according to 10 findings listed in the Kyoto classification of gastritis after reviewing MCCE images. We also developed 2 predictive models to assess H. pylori infection status by combining these 10 findings. RESULTS The MCCE's overall diagnostic accuracy for H. pylori infection status was 80.2%. The sensitivity, specificity and diagnostic odds ratio (DOR) for current infection were 89.4%, 90.1% and 77.1, respectively. Major specific findings were mucosal swelling and spotty redness for current infection, regular arrangement of collecting venules (RAC), streak redness, fundic gland polyp (FGP) for noninfection, and map-like redness for past-infection. In the two prediction models, the area under the curve (AUC) values for predicting noninfection and current infection were 84.7 and 84.9, respectively. CONCLUSIONS The Kyoto classification of gastritis applied well to MCCE. H. pylori infection status could be accurately assessed on MCCE according to the Kyoto classification of gastritis.
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Affiliation(s)
- Sun Xi
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Liu Jing
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wu Lili
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Li Tingting
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Li Jun
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wang Ming
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wang Zhiqiang
- grid.414252.40000 0004 1761 8894Chinese PLA General Hospital, Department of Gastroenterology and Hepatology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Jin Peng
- grid.414252.40000 0004 1761 8894Department of Gastroenterology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
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15
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Adachi K, Kishi K, Sakamoto U, Ishimura N, Ishihara S. Degree of Gastric Mucosal Atrophy Correlated Well with Gastric Cancer Occurrence in Patients with Helicobacter pylori-eradicated Status. Intern Med 2022; 62:1389-1394. [PMID: 36198598 DOI: 10.2169/internalmedicine.0506-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study was performed to clarify the association of the degree of gastric mucosal atrophy (GMA) with the occurrence of gastric cancer in patients with Helicobacter pylori-eradicated status. Subjects and Methods The subjects were 3,058 patients (2,035 men, 1,023 women; mean age 57.9 ± 9.5 years old) with H. pylori eradication who underwent esophago-gastroduodenal endoscopy examinations as part of medical checkups conducted between April 2013 and March 2022. The gender, age at eradication, time since eradication, usage of anti-secretory drugs, degree of endoscopic GMA, and FGP prevalence were compared between subjects with and without gastric cancer occurrence. Results Gastric cancer was newly detected in 26 subjects (0.85%) during the study period, with an older age at H. pylori eradication and severe grade of endoscopic GMA being significant risk factors for its occurrence. The gender, smoking history, and usage of anti-secretory drugs were not significantly different between subjects with and without gastric cancer occurrence. A Cox regression analysis showed that an older age at eradication and the degree of GMA were risk factors significantly related to occurrence. Furthermore, the degree of GMA was inversely correlated with FGP development, and gastric cancer was not detected in 467 subjects with FGP prevalence. Conclusion An older age at the time of H. pylori eradication and the degree of GMA are significant risk factors for gastric cancer occurrence in H. pylori-eradicated patients. The FGP prevalence in subjects with H. pylori eradication was inversely associated with GMA, suggesting it was negatively related with gastric cancer occurrence.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kanako Kishi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Utae Sakamoto
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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16
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Sato C, Takahashi K, Sato H, Naruse T, Nakajima N, Takatsuna M, Mizuno KI, Hashimoto S, Takeuchi M, Yokoyama J, Kobayashi M, Terai S. Endoscopic Findings and Treatment of Gastric Neoplasms in Familial Adenomatous Polyposis. J Gastric Cancer 2022; 22:381-394. [PMID: 36316112 PMCID: PMC9633932 DOI: 10.5230/jgc.2022.22.e30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE Gastric neoplasia is a common manifestation of familial adenomatous polyposis (FAP). This study aimed to elucidate the clinical characteristics, endoscopic features including fundic gland polyposis (FGPsis), and treatment outcomes of gastric neoplasms (GNs) in patients with FAP. MATERIALS AND METHODS A total of 35 patients diagnosed with FAP, including nine patients from four pedigrees who underwent esophagogastroduodenoscopy (EGD), were investigated regarding patient characteristics, GN morphology, and treatment outcomes. RESULTS Twenty-one patients (60.0%) had 38 GNs; 33 (86.8%) and 5 (13.2%) were histologically diagnosed with adenocarcinoma and adenoma, respectively. There were no specific patient characteristics related to GNs. Nodule-type GNs were more prevalent in patients with FGP than without (52.2% vs. 0.0%, P=0.002) in the upper body of the stomach. Conversely, depressed-type GNs were fewer in patients with FGPsis than in those without (13.0% vs. 73.3%, P<0.001). Slightly elevated-type GNs were observed in both groups (34.8% vs. 20.0%, P=0.538). Even within pedigrees, the background gastric mucosa and types of GNs varied. In total, 24 GNs were treated with endoscopic submucosal dissection (ESD) and eight with endoscopic mucosal resection (EMR). EMR was selected for GNs with FGPsis because of the technical difficulty of ESD, resulting in a lower en bloc resection rate (62.5% vs. 100%, P=0.014). CONCLUSIONS Our study indicates the necessity of routine EGD surveillance in patients diagnosed with FAP. Notably, the morphology and location of GNs differed between patients with and without FGPsis. Endoscopic treatment and outcomes require more attention in cases of FGPsis.
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Affiliation(s)
- Chihiro Sato
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuya Takahashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Hiroki Sato
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takumi Naruse
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Nao Nakajima
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Masafumi Takatsuna
- Department of Gastroenterology, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Ken-Ichi Mizuno
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Manabu Takeuchi
- Department of Gastroenterology, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Masaaki Kobayashi
- Department of Gastroenterology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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17
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Moon HS. Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2022. [DOI: 10.5124/jkma.2022.65.5.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Gastric cancer is a global health problem, and the incidence and geographical distribution of different types of gastric cancer varies. Particularly, noncardiac gastric cancer is more prevalent in East Asia, Central and Eastern Europe, Latin America, and Africa. Infection with Helicobacter pylori, which was discovered in 1982, is a common cause of chronic gastritis, and the association between H. pylori infection and gastric adenocarcinoma is well established.Current Concepts: Gastric cancer is histologically divided into 2 types: intestinal and diffuse. H. pylori infection is considered as the main risk factor for the development of both types of gastric tumors. The most documented course of development of stomach cancer is following cellular metaplasia due to chronic inflammation, damage, and repair. Various molecular alterations caused by H. pylori are identified not only in gastric cancer but also in precancerous lesions. Recently, many studies have attempted to diagnose H. pylori gastritis and precancerous lesions using endoscopy.Discussion and Conclusion: Recent studies have shown that eradication therapy stabilizes or reduces the risk of developing gastric cancer. Therefore, the diagnosis and understanding of gastritis and precancerous lesions caused by H. pylori are the first step in the prevention of gastric cancer.
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18
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Adachi K, Ishimura N, Notsu T, Kishi K, Mishiro T, Sota K, Nagano N, Ishihara S. Endoscopic findings of cardiac lymphoid hyperplasia and
Helicobacter pylori
infection status. DEN OPEN 2022; 2:e15. [PMID: 35310767 PMCID: PMC8828233 DOI: 10.1002/deo2.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Accepted: 03/28/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Kyoichi Adachi
- Health Center Shimane Environment and Health Public Corporation Shimane Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine Shimane University Faculty of Medicine Shimane Japan
| | - Takumi Notsu
- Health Center Shimane Environment and Health Public Corporation Shimane Japan
| | - Kanako Kishi
- Health Center Shimane Environment and Health Public Corporation Shimane Japan
| | - Tomoko Mishiro
- Health Center Shimane Environment and Health Public Corporation Shimane Japan
| | - Kazunari Sota
- Health Center Shimane Environment and Health Public Corporation Shimane Japan
| | - Nahoko Nagano
- Pathology Unit Shimane University Hospital Shimane Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine Shimane University Faculty of Medicine Shimane Japan
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Park JM, Lee SY, Kim JH, Sung IK, Park HS. Prognosis of Seronegative Subjects with a Helicobacter pylori-infected Spouse. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2021. [DOI: 10.7704/kjhugr.2021.0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background/Aims: Helicobacter pylori (H. pylori) can disseminate between couples. The present study compared the findings of gastric cancer screening between seronegative subjects according to the presence of an infected spouse.Materials and Methods: Follow-up data of seronegative subjects were analyzed among married couples who underwent gastric cancer screening via gastroscopy, serum pepsinogen, and anti-H. pylori IgG assays between January 2010 and May 2016. New detection rates of H. pylori infection and gastric neoplasm at the follow-up screening were compared between seronegative subjects according to the H. pylori-infected status of spouse.Results: Among 246 seronegative subjects with an H. pylori-infected spouse, 92 underwent follow-up tests (case group). Among 278 seronegative subjects with seronegative spouse, 94 underwent follow-up tests (control group). The past infection rate was higher in the case group than in the control group (52/92 vs. 34/94; P=0.005). New H. pylori infection was diagnosed in three of the 92 cases and two of the 94 controls (3.2% vs. 2.1%; P=0.681). During the mean follow-up of 67.9±36.0 months, three adenocarcinomas and two adenomas (5/184) were newly detected among the cases and their spouses, whereas none (0/188) were detected among the controls and their spouses (2.7% vs. 0%; P=0.029).Conclusions: Gastric neoplasm occurred more frequently in couples with an H. pylori-infected spouse. Because the past infection rate is higher among seronegative subjects with an infected spouse, gastric cancer screening is recommended in both partners when the spouse is infected.
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Chen WQ, Tian FL, Zhang JW, Yang XJ, Li YP. Preventive and inhibitive effects of Yiwei Xiaoyu granules on the development and progression of spasmolytic polypeptide-expressing metaplasia lesions. World J Gastrointest Oncol 2021; 13:1741-1754. [PMID: 34853647 PMCID: PMC8603444 DOI: 10.4251/wjgo.v13.i11.1741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/10/2021] [Accepted: 08/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Spasmolytic polypeptide-expressing metaplasia (SPEM) is a potential preneoplastic lesion.
AIM To elucidate the microRNA (miR)-7-mediated preventive and inhibitive effects of Yiwei Xiaoyu granules (YWXY) in SPEM lesions.
METHODS Gastric mucosa biopsies were collected from chronic atrophic gastritis patients and healthy people with signed informed consent. YWXY was administered to the mice with induced SPEM by tamoxifen, and the gastric mucosa was harvested on the tenth day of the experiment. Then immunohistochemistry and immunofluorescence were performed to validate the SPEM, lesions and the potential mechanism was investigated. RNA transcripts were detected with reverse transcription-quantitative polymerase chain reaction.
RESULTS The expression of miR-7 was downregulated in the SPEM lesions, and expression of trefoil factor 2 (TFF2) and clusterin was high in the human gastric mucosa. In vivo experiments showed that YWXY could inhibit the cell proliferation in the tamoxifen-induced SPEM lesions by regulating Ki67. Simultaneously, YWXY could restore the expression of miR-7 by regulating TFF2 by detection with immunofluorescence but not with reverse transcription-quantitative polymerase chain reaction, indicating its potential mechanism of targeting miR-7 by mediating TFF2. The expression of vascular endothelial growth factor-β and gastric intrinsic factor was restored within 3 d of YWXY administration for the SPEM lesions, speculating that the possible mechanism of YWXY is to inhibit the development and progression of SPEM by regulating vascular endothelial growth factor-β and gastric intrinsic factor.
CONCLUSION miR-7 downregulation is an early event in SPEM through regulation of TFF2 in human gastric mucosa. YWXY is able to inhibit the cell proliferation and restore the expression of miR-7 by mediating TFF2 in the SPEM mouse model.
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Affiliation(s)
- Wan-Qun Chen
- Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
| | - Feng-Liang Tian
- Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
| | - Jin-Wei Zhang
- Department of Dermatology and Cosmetology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
| | - Xiao-Jun Yang
- Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
| | - Yan-Ping Li
- Department of Gastroenterology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
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Weng CY, Xu JL, Sun SP, Wang KJ, Lv B. Helicobacter pylori eradication: Exploring its impacts on the gastric mucosa. World J Gastroenterol 2021; 27:5152-5170. [PMID: 34497441 PMCID: PMC8384747 DOI: 10.3748/wjg.v27.i31.5152] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/14/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infects approximately 50% of all humans globally. Persistent H. pylori infection causes multiple gastric and extragastric diseases, indicating the importance of early diagnosis and timely treatment. H. pylori eradication produces dramatic changes in the gastric mucosa, resulting in restored function. Consequently, to better understand the importance of H. pylori eradication and clarify the subsequent recovery of gastric mucosal functions after eradication, we summarize histological, endoscopic, and gastric microbiota changes to assess the therapeutic effects on the gastric mucosa.
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Affiliation(s)
- Chun-Yan Weng
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Jing-Li Xu
- Department of Gastrointestinal Surgery, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Shao-Peng Sun
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Kai-Jie Wang
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Bin Lv
- Department of Gastroenterology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
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Glover B, Teare J, Patel N. Assessment of Helicobacter pylori status by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000608. [PMID: 34353822 PMCID: PMC8344320 DOI: 10.1136/bmjgast-2021-000608] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/04/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives Helicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing area of research, as are their diagnostic accuracies. This study aimed to establish the diagnostic accuracy of several mucosal features predictive of H. pylori negative status and formulate a simple prediction model for use at the time of endoscopy. Design Patients undergoing high-definition upper gastrointestinal (GI) endoscopy without magnification were recruited prospectively. During the endoscopy, the presence or absence of specific endoscopic findings was noted. Sydney protocol biopsies were used as the diagnostic reference standard, and urease test if taken. The results informed a logistic regression model used to produce a simple diagnostic approach. This model was subsequently validated using a further cohort of 30 patients. Results 153 patients were recruited and completed the study protocol. The prevalence of active H. pylori infection was 18.3% (28/153). The overall diagnostic accuracy of the simple prediction model was 80.0%, and 100% of patients with active H. pylori infection were correctly classified. The presence of regular arrangement of collecting venules (RAC) showed a positive predictive value for H. pylori naïve status of 90.7%, rising to 93.6% for patients under the age of 60. Conclusion A simple endoscopic model may be accurate for predicting H. pylori status of a patient, and the need for biopsy-based tests. The presence of RAC in the stomach is an accurate predictor of H. pylori negative status, particularly in patients under the age of 60. Trial registration number The study was registered with ClinicalTrials.gov, No. NCT02385045.
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Affiliation(s)
- Ben Glover
- Surgery and Cancer, Imperial College London, London, UK
| | - Julian Teare
- Surgery and Cancer, Imperial College London, London, UK
| | - Nisha Patel
- Surgery and Cancer, Imperial College London, London, UK
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Yang H, Hu B. Diagnosis of Helicobacter pylori Infection and Recent Advances. Diagnostics (Basel) 2021; 11:diagnostics11081305. [PMID: 34441240 PMCID: PMC8391489 DOI: 10.3390/diagnostics11081305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infects approximately 50% of the world population. Its infection is associated with gastropathies, extra-gastric digestive diseases, and diseases of other systems. There is a canonical process from acute-on-chronic inflammation, chronic atrophic gastritis (CAG), intestinal metaplasia (IM), dysplasia, and intraepithelial neoplasia, eventually to gastric cancer (GC). H. pylori eradication abolishes the inflammatory response and early treatment prevents the progression to preneoplastic lesions. METHODS the test-and-treat strategy, endoscopy-based strategy, and screen-and-treat strategy are recommended to prevent GC based on risk stratification, prevalence, and patients' clinical manifestations and conditions. Challenges contain false-negative results, increasing antibiotic resistance, decreasing eradication rate, and poor retesting rate. Present diagnosis methods are mainly based on invasive endoscopy and noninvasive laboratory testing. RESULTS to improve the accuracy and effectiveness and reduce the missed diagnosis, some advances were achieved including newer imaging techniques (such as image-enhanced endoscopy (IEE), artificial intelligence (AI) technology, and quantitative real-time polymerase chain reaction (qPCR) and digital PCR (dPCR). CONCLUSION in the article, we summarized the diagnosis methods of H. pylori infection and recent advances, further finding out the opportunities in challenges.
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Adachi K, Kishi K, Sakamoto U, Mishiro T, Okimoto E, Ishimura N, Ishihara S. Factors for Negative Result in Serum Anti-Helicobacter pylori IgG Antibody Test in Adult Subjects With Nodular Gastritis: A Single-center Study. Cureus 2021; 13:e15651. [PMID: 34306861 PMCID: PMC8279802 DOI: 10.7759/cureus.15651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Aim: Nodular gastritis has been demonstrated to be strongly associated with Helicobacter pylori infection. The present retrospective study was performed to elucidate factors related to a negative serum antibody test result in adults with nodular gastritis. Materials and methods: We investigated 116 H. pylori-positive subjects endoscopically diagnosed with nodular gastritis and subjected to a serum anti-H. pylori immunoglobulin G (IgG) antibody test. The degree of gastric mucosal atrophy and the presence of spotty redness in the gastric body and fornix were carefully determined by observations of endoscopic images. Results: Of the 116 investigated subjects, 108 were positive and 8 negative in serum anti-H. pylori IgG antibody test results. The degree of gastric mucosal atrophy was mild in seven among eight seronegative cases. The levels of pepsinogen II in serum in patients with negative antibody test findings were significantly lower as compared to those found positive, while the pepsinogen I/II ratio tended to be higher in subjects shown negative by the test. Only 1 of 69 with spotty redness was negative in serum anti-H. pylori IgG antibody testing, while 7 of 47 without spotty redness were negative. Multiple logistic regression analysis of subjects with a negative test result revealed that the absence of spotty redness shown by endoscopy was a significant risk factor. Conclusion: The absence of spotty redness, which may reflect the degree of gastric body inflammation, is a significant factor indicating increased risk for a negative serum anti-H. pylori IgG antibody test result in subjects with nodular gastritis.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Kanako Kishi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Utae Sakamoto
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN
| | - Eiko Okimoto
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, JPN
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, JPN
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25
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Ebigbo A, Marienhagen J, Messmann H. Regular arrangement of collecting venules and the Kimura-Takemoto classification for the endoscopic diagnosis of Helicobacter pylori infection: Evaluation in a Western setting. Dig Endosc 2021; 33:587-591. [PMID: 32767790 DOI: 10.1111/den.13808] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The regular arrangement of collecting venules (RAC) and the Kimura-Takemoto classification of atrophic change (KTC) are simple and easy-to-use criteria which have been shown to reliably predict or rule out a Helicobacter pylori infection of the stomach. Although these features have been investigated extensively in Asia, their significance in the West has not been evaluated. METHODS In a series of 200 consecutive gastroscopic examinations (single examiner, single center), the presence or absence of RAC and the KTC grade (open type vs closed type) were recorded prospectively. Helicobacter pylori infection was defined as a positive histology or a positive rapid urease test. Furthermore, multivariate analysis of endoscopic predictors of H. pylori infection based on the Kyoto classification of gastritis was performed. RESULTS Two hundred patients were examined of which 57 had a H. pylori infection (28%). Both RAC and KTC had excellent negative predictive values of about 90% and sensitivity values of up to 85%. In multivariate analysis, atrophic change and diffuse redness without RAC were significantly associated with H. pylori infection. CONCLUSION Regular arrangement of collecting venules and KTC are simple endoscopic features which should be given attention by Western endoscopists and can be easily used to rule out a H. pylori infection of the stomach.
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Affiliation(s)
- Alanna Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | | | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
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Upper Gastrointestinal Lesions during Endoscopy Surveillance in Patients with Lynch Syndrome: A Multicentre Cohort Study. Cancers (Basel) 2021; 13:cancers13071657. [PMID: 33916129 PMCID: PMC8038061 DOI: 10.3390/cancers13071657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/18/2021] [Accepted: 03/28/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Patients with Lynch syndrome are at increased risk of upper gastrointestinal cancer. Recommendations for upper gastrointestinal endoscopy screening vary widely with limited data supporting effectiveness. The aim of our study was to investigate yields of upper gastrointestinal endoscopy screening in a large multicentre cohort of 172 Lynch syndrome mutation carriers. In our study, upper gastrointestinal endoscopy surveillance detects frequent neoplastic lesions particularly after the age of 40 years. Ours results suggest that Lynch patients should be considered for upper gastrointestinal endoscopic and Helicobacter pylori screening. Abstract Background: Patients with Lynch syndrome are at increased risk of gastric and duodenal cancer. Upper gastrointestinal endoscopy surveillance is generally proposed, even though little data are available on upper gastrointestinal endoscopy in these patients. The aim of this retrospective study was to evaluate the prevalence and incidence of gastrointestinal lesions following upper gastrointestinal endoscopy examination in Lynch patients. Methods: A large, multicentre cohort of 172 patients with a proven germline mutation in one of the mismatch repair genes and at least one documented upper gastrointestinal endoscopy screening was assessed. Detailed information was collected on upper gastrointestinal endoscopy findings and the outcome of endoscopic follow-up. Results: Seventy neoplastic gastrointestinal lesions were diagnosed in 45 patients (26%) out of the 172 patients included. The median age at diagnosis of upper gastrointestinal lesions was 54 years. The prevalence of cancer at initial upper gastrointestinal endoscopy was 5% and the prevalence of precancerous lesions was 12%. Upper gastrointestinal lesions were more frequent after 40 years of age (p < 0.001). Helicobacter pylori infection was associated with an increased prevalence of gastric, but not duodenal, lesions (p < 0.001). Conclusions: Neoplastic upper gastrointestinal lesions are frequent in patients with Lynch syndrome, especially in those over 40 years of age. The results of our study suggest that Lynch patients should be considered for upper gastrointestinal endoscopic and Helicobacter pylori screening.
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Adachi K, Ishimura N, Kishi K, Notsu T, Mishiro T, Sota K, Ishihara S. Prevalence of Barrett's Epithelium Shown by Endoscopic Observations with Linked Color Imaging in Subjects with Different H. pylori Infection Statuses. Intern Med 2021; 60:667-674. [PMID: 32999237 PMCID: PMC7990643 DOI: 10.2169/internalmedicine.5676-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective This study was conducted to clarify the prevalence of short segment Barrett's esophagus (SSBE) using endoscopic observations with linked color imaging (LCI). In addition, the relationship between the presence of Barrett's epithelium (BE) and the status of H. pylori infection was investigated. Methods The study subjects were 3,353 individuals (2,186 men, 1,167 women; mean age 55.2±9.4 years old) whose status of H. pylori infection had been determined. An endoscopic observation using LCI was performed to examine the distal margin of palisade vessels and confirm the area of BE. The prevalence of BE ≥5 mm in length was investigated. Results BE was diagnosed in 1,884 (56.2%) subjects, with lengths of <10, 10-19, 20-29, and ≥30 mm found in 1,005, 851, 27, and 1, respectively. Its prevalence in H. pylori-negative, H. pylori-positive, and post-eradicated subjects was 41.7%, 64.4%, and 69.9%, respectively (p<0.001). The duration since successful eradication of H. pylori did not affect the prevalence of BE. The degree of gastric mucosal atrophy was higher in cases with BE (p<0.001), although negativity for H. pylori infection and mild gastric mucosal atrophy were significant factors for the development of longer BE. Conclusion A high prevalence of SSBE was noted when LCI was used to determine the area of BE, as the distal end of the palisade vessels was easily visualized. Negativity for H. pylori infection and mild gastric mucosal atrophy were not correlated with SSBE prevalence.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
| | - Kanako Kishi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kazunari Sota
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Cho H, Yamada M, Sekine S, Tanabe N, Ushiama M, Hirata M, Ogawa G, Gotoh M, Yoshida T, Yoshikawa T, Saito Y, Kuchiba A, Oda I, Sugano K. Gastric cancer is highly prevalent in Lynch syndrome patients with atrophic gastritis. Gastric Cancer 2021; 24:283-291. [PMID: 32794040 DOI: 10.1007/s10120-020-01113-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although gastric cancer is one of the Lynch syndrome (LS)-related tumors, the clinicopathological features of gastric cancer in patients with LS remain uncertain. To investigate the incidence risk and clinicopathological features of gastric neoplasms in LS, we conducted a retrospective cohort study in Japanese LS patients. METHODS LS patients with pathogenic mismatch repair (MMR) gene variants were extracted from the LS registry of the National Cancer Center Hospital, Japan. Cumulative risks of gastric neoplasm, including dysplasia and cancer, were estimated using the Kaplan-Meier method. Gastric atrophy was evaluated endoscopically and/or histologically. Immunohistochemical staining for MMR proteins was performed for all available specimens. RESULTS Of 118 eligible patients, 26 patients were diagnosed with 58 gastric neoplasms. The cumulative incidence of gastric neoplasm was 41.0% (95% confidence interval, 26.9-55.0) at the age of 70. Of these, 13 (50%) patients developed synchronous and/or metachronous multiple gastric neoplasms. Among the 49 gastric neoplasms available for detailed pathological evaluation, all were associated with intestinal metaplasia. Immunohistochemically, 42 (86%) were MMR-deficient. The individuals with gastric atrophy had a significantly higher risk of developing gastric neoplasms compared with those without gastric atrophy (26 cases/54 individuals vs. 0 cases/53 individuals) (P = 0.026). CONCLUSION LS patients, particularly those with atrophic gastritis, are at high risk of gastric neoplasm and often develop multiple tumors. Endoscopic surveillance for gastric cancer is recommended for LS patients, especially those with atrophic gastritis.
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Affiliation(s)
- Hourin Cho
- Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masayoshi Yamada
- Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Shigeki Sekine
- Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Noriko Tanabe
- Department of Genetic Medicine and Services, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Mineko Ushiama
- Department of Genetic Medicine and Services, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Department of Clinical Genomics, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Makoto Hirata
- Department of Genetic Medicine and Services, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Gakuto Ogawa
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masahiro Gotoh
- Department of Clinical Genomics, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Teruhiko Yoshida
- Department of Genetic Medicine and Services, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takaki Yoshikawa
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kokichi Sugano
- Department of Genetic Medicine and Services, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Oncogene Research Unit/Cancer Prevention Unit, Tochigi Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Zhao J, Xu S, Gao Y, Lei Y, Zou B, Zhou M, Chang D, Dong L, Qin B. Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study. Front Oncol 2020; 10:599218. [PMID: 33344250 PMCID: PMC7746828 DOI: 10.3389/fonc.2020.599218] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022] Open
Abstract
Background There is lack of clinical evidence supporting the value of the Kyoto classification of gastritis for the diagnosis of Helicobacter pylori (H. pylori) infection in Chinese patients, and there aren’t enough specific features for the endoscopic diagnosis of past infections, which is of special significance for the prevention of early gastric cancer (GC). Methods This was a prospective and multicenter study with 650 Chinese patients. The H. pylori status and gastric mucosal features, including 17 characteristics based on the Kyoto classification and two newly-defined features unclear atrophy boundary (UAB) and RAC reappearance in atrophic mucosa (RAC reappearance) were recorded in a blind fashion. The clinical characteristics of the subjects were analyzed, and the diagnostic odds ratio (DOR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristics curve (ROC/AUC), and 95% confidence intervals were calculated for the different features, individually, and in combination. Results For past infection, the DOR of UAB was 7.69 (95%CI:3.11−19.1), second only to map-like redness (7.78 (95%CI: 3.43−17.7)). RAC reappearance showed the highest ROC/AUC (0.583). In cases in which at least one of these three specific features of past infection was considered positive, the ROC/AUC reached 0.643. For current infection, nodularity showed the highest DOR (11.7 (95%CI: 2.65−51.2)), followed by diffuse redness (10.5 (95%CI: 4.87−22.6)). Mucosal swelling showed the highest ROC/AUC (0.726). Regular arrangement of collecting venules (RAC) was specific for no infection. Conclusions This study provides evidence of the clinical accuracy and robustness of the Kyoto classification of gastritis for the diagnosis of H. pylori in Chinese patients, and confirms UAB and RAC reappearance partly supplement it for the diagnosis of past infections, which is of great benefit to the early prevention of GC.
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Affiliation(s)
- Jing Zhao
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shaoxian Xu
- Department of Gastroenterology, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yuan Gao
- Department of Gastroenterology, Ankang Central Hospital, Ankang, China
| | - Yali Lei
- Department of Gastroenterology, Weinan Central Hospital, Weinan, China
| | - Baicang Zou
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mimi Zhou
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Danyan Chang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lei Dong
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bin Qin
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Adachi K, Kishi K, Notsu T, Mishiro T, Sota K, Ishimura N, Ishihara S. Serum Anti-Helicobacter pylori IgG Antibody Titer in H. pylori-negative Cases with a Different Gastric Mucosal Atrophy Status. Intern Med 2020; 59:2817-2823. [PMID: 32713919 PMCID: PMC7725629 DOI: 10.2169/internalmedicine.5132-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective This retrospective study was performed to investigate the anti-Helicobacter pylori IgG antibody serum titers in H. pylori-negative subjects with different degrees of gastric mucosal atrophy including C0 grade atrophy. Methods The absence of H. pylori infection was determined based on both negative serum anti-H. pylori IgG antibody test findings and no endoscopic evidence of that infection. Cases negative for the antibody and with positive endoscopic findings of H. pylori infection were defined as H. pylori-positive. The serum anti-H. pylori IgG antibody titers were analyzed in H. pylori-negative (n=1,087), -positive (n=69), and post-eradicated (n=278) subjects. Results The serum antibody titer in subjects with H. pylori-positive endoscopy findings was significantly higher than that in H. pylori-negative subjects, even when the serum titer indicated a negative result. In addition, the anti-H. pylori IgG antibody serum titer was higher in H. pylori-negative subjects with a greater degree of gastric mucosal atrophy. In a comparison between H. pylori-negative C0 and C1 gastric mucosal atrophy cases, the antibody serum titer in those classified as C0 was significantly lower. An analysis of H. pylori post-eradicated cases showed that the serum antibody titer decreased over time after successful eradication. Conclusion The disappearance of H. pylori infection in H. pylori-negative individuals may occur later in those with a greater degree of gastric mucosal atrophy. The serum antibody titer difference between the H. pylori-negative C0 and C1 groups might have been caused by the differences in distribution between H. pylori-uninfected subjects and those in whom the infection had disappeared, thus additional investigation is needed to clarify the significance of gastric mucosal classification including the C0 grade.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kanako Kishi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kazunari Sota
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Glover B, Teare J, Ashrafian H, Patel N. The endoscopic predictors of Helicobacter pylori status: a meta-analysis of diagnostic performance. Ther Adv Gastrointest Endosc 2020; 13:2631774520950840. [PMID: 33150333 PMCID: PMC7586493 DOI: 10.1177/2631774520950840] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/08/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: The endoscopic findings associated with Helicobacter pylori–naïve status, current infection or past infection are an area of ongoing interest. Previous studies have investigated parameters with a potential diagnostic value. The aim of this study was to perform meta-analysis of the available literature to validate the diagnostic accuracy of mucosal features proposed in the Kyoto classification. Data sources: The databases of MEDLINE and Embase, clinicalTrials.gov and the Cochrane Library were systematically searched for relevant studies from October 1999 to October 2019. Methods: A bivariate random effects model was used to produce pooled diagnostic accuracy calculations for each of the studied endoscopic findings. Diagnostic odds ratios and sensitivity and specificity characteristics were calculated to identify significant predictors of H pylori status. Results: Meta-analysis included 4380 patients in 15 studies. The most significant predictor of an H pylori-naïve status was a regular arrangement of collecting venules (diagnostic odds ratio 55.0, sensitivity 78.3%, specificity 93.8%). Predictors of active H pylori infection were mucosal oedema (18.1, 63.7%, 91.1%) and diffuse redness (14.4, 66.5%, 89.0%). Map-like redness had high specificity for previous H pylori eradication (99.0%), but poor specificity (13.0%). Conclusion: The regular arrangement of collecting venules, mucosal oedema, diffuse redness and map-like redness are important endoscopic findings for determining H pylori status. This meta-analysis provides a tentative basis for developing future endoscopic classification systems.
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Ohno A, Miyoshi J, Kato A, Miyamoto N, Yatagai T, Hada Y, Kusuhara M, Jimbo Y, Ida Y, Tokunaga K, Okamoto S, Hisamatsu T. Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after Helicobacter pylori eradication -analysis based on the Kyoto classification. BMC Gastroenterol 2020; 20:232. [PMID: 32689949 PMCID: PMC7370417 DOI: 10.1186/s12876-020-01375-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023] Open
Abstract
Background Gastric cancer after Helicobacter pylori (HP) eradication is a crucial clinical challenge today as HP eradication therapy is widely performed. Detecting gastric cancer after HP eradication tends to be difficult with normal white-light endoscopy. In the present study, we aimed to identify easily-evaluated endoscopic findings that indicate the presence of gastric cancer after HP eradication so that endoscopists can consider additional detailed examinations at the site. Methods We analyzed the endoscopic images of 43 patients who underwent endoscopic submucosal dissection for early gastric cancer after HP eradication and 119 patients with an HP eradication history who underwent esophagogastroduodenoscopy for a medical checkup. Endoscopic findings were evaluated according to the Kyoto classification of gastritis (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) and map-like redness. Results Patients with gastric cancer had significantly higher total Kyoto risk scores; more atrophy, intestinal metaplasia, and diffuse redness; and a significantly higher prevalence of map-like redness compared with those without gastric cancer, in the univariate analyses. We used logistic regression analysis with forward selection based on the likelihood ratio to develop a model using atrophy and diffuse redness. Receiver operating characteristic analysis showed that a score of A2 in the Kyoto classification of gastritis (open-type atrophic pattern in the Kimura–Takemoto classification) was an endoscopic marker for the presence of post-HP-eradication gastric cancer. Conclusions Endoscopic severe gastric mucosal atrophy is useful to screen patients for gastric cancer after HP eradication.
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Affiliation(s)
- Akiko Ohno
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Jun Miyoshi
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
| | - Atsushi Kato
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Naohiko Miyamoto
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Takahito Yatagai
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Yu Hada
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Mitsunori Kusuhara
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Yoko Jimbo
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Yosuke Ida
- Department of General Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Kengo Tokunaga
- Department of General Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Susumu Okamoto
- Department of General Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
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Notsu T, Adachi K, Mishiro T, Ishimura N, Ishihara S. Fundic gland polyp prevalence according to Helicobacter pylori infection status. J Gastroenterol Hepatol 2020; 35:1158-1162. [PMID: 31734951 DOI: 10.1111/jgh.14934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM The prevalence of fundic gland polyp (FGP) occurrence has not been clarified in individuals with Helicobacter pylori infection post-eradicated status. This study was performed to examine the relationship between FGP prevalence and H. pylori infection status. METHODS We enrolled 3400 subjects (2185 male subjects and 1215 female subjects; mean age 54.7 ± 9.5 years) with known H. pylori infection status and who underwent an upper gastrointestinal endoscopy examination as part of an annual check-up. Subjects without and with H. pylori infection numbered 1617 and 239, respectively, while 1544 had a post-eradication status. The presence of FGP and degree of gastric mucosal atrophy were determined in each subject using an endoscopic method. RESULTS Endoscopy findings showed FGPs in 1029 (30.3%) of all subjects. The prevalence ratio of FGP positivity in H. pylori-negative, H. pylori-positive, and post-eradicated subjects was 51.9%, 1.7%, and 12.0%, respectively. Multiple logistic regression analysis revealed that female gender, older age, milder gastric mucosal atrophy, and anti-secretory therapy were significant risk factors for FGP occurrence. As compared with H. pylori-positive subjects, the odds ratios for H. pylori-negative and post-eradication status were 48.3 and 6.6, respectively (P < 0.001). In the post-eradication status subjects, longer duration following bacterial eradication was a significant risk factor for occurrence of FGPs. CONCLUSION The risk of FGP occurrence in individuals who have undergone H. pylori eradication treatment is lower as compared with those who have never been infected. However, that risk increases over time following eradication.
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Affiliation(s)
- Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan
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Nakano K, Kawachi H, Chino A, Kita M, Arai M, Ide D, Saito S, Yoshimizu S, Horiuchi Y, Ishiyama A, Yoshio T, Hirasawa T, Tsuchida T, Fujisaki J. Phenotypic variations of gastric neoplasms in familial adenomatous polyposis are associated with endoscopic status of atrophic gastritis. Dig Endosc 2020; 32:547-556. [PMID: 31411765 DOI: 10.1111/den.13512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/09/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Gastric neoplasms (GN), including gastric adenoma and carcinoma, are well known as extracolonic manifestations of familial adenomatous polyposis (FAP). We aimed to investigate the clinicopathological features of GN in FAP patients and to clarify their relationship with the endoscopic status of the background mucosa. METHODS We analyzed the records of 39 patients who were diagnosed with FAP and underwent esophagogastroduodenoscopy between April 2005 and July 2016. Patients were divided into two groups according to atrophic gastritis (AG) status. Endoscopic findings of GN and background mucosa, and histopathological findings, including phenotypic expression of GN and mutation locus of adenomatous polyposis coli (APC) gene, were evaluated. RESULTS Gastric neoplasms were more predominant in the AG-positive group than in the AG-negative group (6/9, 66.7% vs 7/30, 23.3%; P = 0.039). Of 36 GN detected in 13 patients, six GN in five patients were followed and 30 GN in eight patients were endoscopically resected and analyzed. GN in the AG-negative group frequently showed whitish color, were located in the proximal stomach, and presented the gastric immunophenotype compared to GN in the AG-positive group. All GN were intramucosal lesions and were curatively resected regardless of AG status. APC germline mutations were identified in 32 patients. In patients with GN, a significantly higher number of mutation loci were among exons 10-15 (codons 564-1465). CONCLUSION Clinicopathological characteristics and phenotypic expressions of GN in FAP patients depend on background mucosa status with or without AG. These findings are useful for detecting GN in FAP patients.
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Affiliation(s)
- Kaoru Nakano
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan.,Department of Pathology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Hiroshi Kawachi
- Department of Pathology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Akiko Chino
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Mizuho Kita
- Department of Clinical Genetic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Masami Arai
- Department of Clinical Genetic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan.,Diagnostics and Therapeutics of Intractable Diseases, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Daisuke Ide
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Shoichi Saito
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Shoichi Yoshimizu
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Yusuke Horiuchi
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Akiyoshi Ishiyama
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Toshiaki Hirasawa
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Tomohiro Tsuchida
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
| | - Junko Fujisaki
- Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan
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Imamura K, Haruma K, Matsumoto H, Maruyama Y, Ayaki M, Tazaki S, Hisamoto N, Manabe N, Kamada T, Kawamoto H. Clinical and endoscopic characteristics of eosinophilic esophagitis in Japan: a case-control study. Asia Pac Allergy 2020; 10:e16. [PMID: 32411581 PMCID: PMC7203441 DOI: 10.5415/apallergy.2020.10.e16] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/21/2020] [Indexed: 12/29/2022] Open
Abstract
Background Eosinophilic esophagitis (EoE) is an allergy-associated clinicopathologic condition gaining an increasing amount of recognition in various areas of the world. While the clinical definition and characteristics may differ depending on country and region, sufficient studies have not yet been performed in Japan. Objective To assess the prevalence of EoE among the Japanese population and the clinical features associated with the disease. Methods Endoscopic data from January 2012 to October 2018 was gathered from 9 Japanese clinical institutes. EoE, defined as esophageal mucosal eosinophilia of at least 15 eosinophils per high-power field, was determined based on esophageal biopsies. Clinical and endoscopic patterns in the cases with EoE were investigated and compared with 186 age- and sex-matched controls. Results From 130,013 upper endoscopic examinations, 66 cases of EoE were identified (0.051%; mean age, 45.2 years [range, 7-79 years]; 45 males). Twenty-five patients (37.9%) with EoE were diagnosed by endoscopy during a medical check-up. Patients with EoE had more symptoms (69.7% vs. 10.8%, p < 0.01) such as dysphagia and food impaction, and more allergies (65.2% vs. 23.7%, p < 0.01) compared with the controls. The prevalence of atrophic gastritis was lower in EoE patients than in the controls (20.0% vs. 33.3%, p < 0.05). Conclusion The prevalence of EoE in the Japanese population was 0.051% which was comparable with previous reports in Japan. History of allergies and the absence of atrophic gastritis were associated with EoE.
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Affiliation(s)
- Kazumi Imamura
- Department of Internal Medicine, Public Mitsugi General Hospital, Onomichi, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hiroshi Matsumoto
- Department of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan
| | - Yasuhiko Maruyama
- Department of Gastrointestinal Medicine, Fujieda Municipal General Hospital, Fujieda, Japan
| | - Maki Ayaki
- Department of Gastrointestinal Medicine, Sakaide City Hospital, Sakaide, Japan
| | - Shuhei Tazaki
- Tazaki Medicine Gastroenterology Clinic, Tokyo, Japan
| | | | - Noriaki Manabe
- Department of Endoscopy and Ultrasound, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
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Toyoshima O, Nishizawa T, Koike K. Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis. World J Gastroenterol 2020; 26:466-477. [PMID: 32089624 PMCID: PMC7015719 DOI: 10.3748/wjg.v26.i5.466] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/15/2020] [Accepted: 01/18/2020] [Indexed: 02/06/2023] Open
Abstract
Recent advances in endoscopic technology allow detailed observation of the gastric mucosa. Today, endoscopy is used in the diagnosis of gastritis to determine the presence/absence of Helicobacter pylori (H. pylori) infection and evaluate gastric cancer risk. In 2013, the Japan Gastroenterological Endoscopy Society advocated the Kyoto classification, a new grading system for endoscopic gastritis. The Kyoto classification organized endoscopic findings related to H. pylori infection. The Kyoto classification score is the sum of scores for five endoscopic findings (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness with or without regular arrangement of collecting venules) and ranges from 0 to 8. Atrophy, intestinal metaplasia, enlarged folds, and nodularity contribute to gastric cancer risk. Diffuse redness and regular arrangement of collecting venules are related to H. pylori infection status. In subjects without a history of H. pylori eradication, the infection rates in those with Kyoto scores of 0, 1, and ≥ 2 were 1.5%, 45%, and 82%, respectively. A Kyoto classification score of 0 indicates no H. pylori infection. A Kyoto classification score of 2 or more indicates H. pylori infection. Kyoto classification scores of patients with and without gastric cancer were 4.8 and 3.8, respectively. A Kyoto classification score of 4 or more might indicate gastric cancer risk.
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Affiliation(s)
- Osamu Toyoshima
- Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Toshihiro Nishizawa
- Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo 108-8329, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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Dohi O, Majima A, Naito Y, Yoshida T, Ishida T, Azuma Y, Kitae H, Matsumura S, Mizuno N, Yoshida N, Kamada K, Itoh Y. Can image-enhanced endoscopy improve the diagnosis of Kyoto classification of gastritis in the clinical setting? Dig Endosc 2020; 32:191-203. [PMID: 31550395 DOI: 10.1111/den.13540] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 02/06/2023]
Abstract
Endoscopic diagnosis of Helicobacter pylori (H. pylori) infection, the most common cause of gastric cancer, is very important to clarify high-risk patients of gastric cancer for reducing morbidity and mortality of gastric cancer. Recently, the Kyoto classification of gastritis was developed based on the endoscopic characteristics of H. pylori infection-associated gastritis for clarifying H. pylori infection status and evaluating risk factors of gastric cancer. Recently, magnifying endoscopy with narrow-band imaging (NBI) has reported benefits of the accuracy and reproducibility of endoscopic diagnosis for H. pylori-related premalignant lesions. In addition to NBI, various types of image-enhanced endoscopies (IEEs) are available including autofluorescence imaging, blue laser imaging, and linked color imaging. This review focuses on understanding the clinical applications and the corresponding evidences shown to improve the diagnosis of gastritis based on Kyoto classification using currently available advanced technologies of IEEs.
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Affiliation(s)
- Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Majima
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Gastroenterology and Hepatology, Omihachiman Community Medical Center, Shiga, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takuma Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsugitaka Ishida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Azuma
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Kitae
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinya Matsumura
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoki Mizuno
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiro Kamada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Yoshii S, Mabe K, Watano K, Ohno M, Matsumoto M, Ono S, Kudo T, Nojima M, Kato M, Sakamoto N. Validity of endoscopic features for the diagnosis of Helicobacter pylori infection status based on the Kyoto classification of gastritis. Dig Endosc 2020; 32:74-83. [PMID: 31309632 DOI: 10.1111/den.13486] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/09/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Evaluation of Helicobacter pylori infection status (non-infection, past infection, current infection) has become important. This study aimed to determine the usefulness of the Kyoto classification of gastritis for diagnosing H. pylori infection status by endoscopy. METHODS In this prospective study, 498 subjects were recruited. Seven well-experienced endoscopists blinded to the history of eradication therapy performed the examinations. Endoscopic findings were assessed according to the Kyoto classification of gastritis: diffuse redness, regular arrangement of collecting venules (RAC), fundic gland polyp (FGP), atrophy, xanthoma, hyperplastic polyp, map-like redness, intestinal metaplasia, nodularity, mucosal swelling, white and flat elevated lesion, sticky mucus, depressive erosion, raised erosion, red streak, and enlarged folds. We established prediction models according to a machine learning procedure and compared them with general assessment by endoscopists using the Kyoto classification of gastritis. RESULTS Significantly higher diagnostic odds were obtained for RAC (32.2), FGP (7.7), and red streak (4.7) in subjects with non-infection, map-like redness (12.9) in subjects with past infection, and diffuse redness (26.8), mucosal swelling (13.3), sticky mucus (10.2) and enlarged fold (8.6) in subjects with current infection. The overall diagnostic accuracy rate was 82.9% with the Kyoto classification of gastritis. The diagnostic accuracy of the prediction model was 88.6% for the model without H. pylori eradication history and 93.4% for the model with eradication history. CONCLUSIONS The Kyoto classification of gastritis is useful for diagnosing H. pylori infection status based on endoscopic findings. Our prediction model is helpful for novice endoscopists. (UMIN000016674).
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Affiliation(s)
- Shinji Yoshii
- Department of Gastroenterology, Sapporo Medical Center NTT EC, Hokkaido, Japan
| | - Katsuhiro Mabe
- Department of Gastroenterology, Hakodate National Hospital, Hokkaido, Japan
| | - Keiko Watano
- Medical Check-up Center, Sapporo Medical Center NTT EC, Hokkaido, Japan
| | - Masayoshi Ohno
- Division of Endoscopy, Hokkaido University Hospital, Hokkaido, Japan
| | - Mio Matsumoto
- Department of Gastroenterology, Hokkaido Medical Center, Hokkaido, Japan
| | - Shoko Ono
- Division of Endoscopy, Hokkaido University Hospital, Hokkaido, Japan
| | - Takahiko Kudo
- Department of Gastroenterology, Health Sciences University of Hokkaido Hospital, Hokkaido, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - Mototsugu Kato
- Department of Gastroenterology, Hakodate National Hospital, Hokkaido, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Hokkaido
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Majima A, Dohi O, Takayama S, Hirose R, Inoue K, Yoshida N, Kamada K, Uchiyama K, Ishikawa T, Takagi T, Handa O, Konishi H, Naito Y, Itoh Y. Linked color imaging identifies important risk factors associated with gastric cancer after successful eradication of Helicobacter pylori. Gastrointest Endosc 2019; 90:763-769. [PMID: 31299258 DOI: 10.1016/j.gie.2019.06.043] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Limited studies have evaluated the risk factors of gastric cancer (GC) after eradication of Helicobacter pylori (H pylori) using endoscopic findings. We aimed to investigate GC detection-related endoscopic findings after eradication of H pylori using linked color imaging (LCI), a novel image-enhanced endoscopy. METHODS This single-center, cross-sectional study evaluated background mucosa-associated endoscopic findings described in the Kyoto classification of gastritis in patients with newly detected GC after eradication of H pylori (CA group, n = 109) and those without GC (NC group, n = 85) using white-light imaging (WLI) and LCI. RESULTS Severe atrophy and map-like redness were significantly more frequent in the CA group than in the NC group using WLI (79.8% vs 63.5%, P = .01; 61.5% vs 37.7%, P = .001, respectively) and LCI (79.8% vs 63.5%, P = .01; 78.0% vs 45.9%, P < .0001, respectively). Regular arrangement of collecting venules (RAC) was significantly less frequent in the CA group than in the NC group using WLI (40.3% vs 64.7%, P = .0009) and LCI (37.6% vs 62.4%, P = .0006). Map-like redness was an independent positive risk factor (WLI: odds ratio [OR], 2.05; 95% confidence interval [CI], 1.09-3.87; P = .03; LCI: OR, 3.62; 95% CI, 1.88-6.97; P < .001), whereas RAC was an independent negative risk factor (WLI: OR, 0.42; 95% CI, 0.21-0.82; P = .01; LCI: OR, 0.46; 95% CI, 0.23-0.93, P = .03) for detection of GC after eradication of H pylori. CONCLUSIONS Map-like redness, which was identified more frequently using LCI than WLI, and the absence of RAC were associated with detection of GC after eradication of H pylori.
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Affiliation(s)
- Atsushi Majima
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Gastroenterology and Hepatology, Omihachiman Community Medical Center, Omihachiman, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shun Takayama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryohei Hirose
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ken Inoue
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiro Kamada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiko Uchiyama
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Ishikawa
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohisa Takagi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osamu Handa
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideyuki Konishi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Adachi K, Notsu T, Mishiro T, Kinoshita Y. Long-term effect of Helicobacter pylori eradication on prevalence of reflux esophagitis. J Gastroenterol Hepatol 2019; 34:1963-1967. [PMID: 31111517 DOI: 10.1111/jgh.14730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/06/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM This study aimed to clarify the long-term effect of Helicobacter pylori eradication on the prevalence of reflux esophagitis (RE). METHODS We enrolled 8123 individuals (male 5286, female 2837; mean age 54.2 ± 9.3 years) who visited our medical center for an annual checkup between April 2016 and December 2018 and in whom the status of H. pylori infection could be determined. The presence of endoscopically proven RE was determined and compared based on that infection status. RESULTS Reflux esophagitis was observed in 898 subjects (11.1%). The rates of prevalence in subjects without and with H. pylori infection and with a post-eradication status were 14.0%, 3.7%, and 10.1%, respectively (P < 0.001). Multiple logistic regression analysis of those positive for RE showed male gender, elevated body mass index, habitual drinking, habitual smoking, larger diaphragmatic hiatus size, and milder gastric mucosal atrophy to be significant risk factors. As compared with H. pylori negative, the odds ratios for H. pylori-positive and post-eradication status were 0.225 and 0.703, respectively. When post-eradication subjects were divided according to duration following eradication, RE prevalence was increased in association with a longer duration. Multiple logistic regression analysis revealed longer duration after H. pylori eradication to be a significant risk factor for RE. CONCLUSIONS The risk of RE developing in individuals following eradication of H. pylori is considered to be lower as compared with those never infected. However, the risk for RE increases as the period following H. pylori eradication is extended.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan
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Garcés-Durán R, García-Rodríguez A, Córdova H, Cuatrecasas M, Ginès À, González-Suárez B, Araujo I, Llach J, Fernández-Esparrach G. Association between a regular arrangement of collecting venules and absence of Helicobacter pylori infection in a European population. Gastrointest Endosc 2019; 90:461-466. [PMID: 31108089 DOI: 10.1016/j.gie.2019.05.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Helicobacter pylori is the major cause of gastritis and gastritis-associated diseases. Detection of a regular arrangement of collecting venules (RAC) in the lesser gastric curvature correlates with negative H pylori status with a sensitivity and negative predictive value (NPV) higher than 90% in Asian countries. The aim of the study was to evaluate the value of RAC as a diagnostic method of H pylori infection in a European population. METHODS A prospective study with high-definition endoscopes without magnification was performed by 3 endoscopists. The presence of starfish-like minute points regularly distributed throughout the lesser curvature of the gastric body was considered RAC positive (RAC+). Gastric biopsies were performed during the procedure for H pylori diagnosis. RESULTS One hundred forty patients were included from February 2017 to May 2018. The prevalence of H pylori infection was 31% and 47 of 140 patients (34%) were RAC+; 13 of 23 patients in whom H pylori was eradicated were RAC+. The mean age of RAC+ patients was lower (44.4 vs 52.4 years, P = .004) and they had less- significant endoscopic findings (9; 19.1% vs 38; 80.9%; P = .017). Gender, use of nonsteroidal anti-inflammatory drugs, antithrombotic or anticoagulants treatments, and a history of H pylori eradication did not show differences in the RAC pattern. The absence of RAC was associated with H pylori infection in 47.3% (44/93) of cases. In contrast, all RAC+ patients were free of H pylori infection, with sensitivity and NPV of 100% for the exclusion of H pylori infection. CONCLUSION The presence of RAC+ in the lesser curvature evaluated with high-definition endoscopy can accurately identify patients without H pylori.
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Affiliation(s)
- Rodrigo Garcés-Durán
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Ana García-Rodríguez
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Henry Córdova
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Miriam Cuatrecasas
- Pathology Department, CDB, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Banc de Tumors Biobanc Clínic-IDIBAPS, Barcelona, Catalonia, Spain
| | - Àngels Ginès
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Begoña González-Suárez
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Isis Araujo
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Josep Llach
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
| | - Gloria Fernández-Esparrach
- Endoscopy Unit, ICMDiM, IDIBAPS, CIBEREHD, Hospital Clínic, University of Barcelona, Barcelona, Catalonia
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Notsu T, Adachi K, Mishiro T, Fujihara H, Toda T, Takaki S, Kinoshita Y. Prevalence of Autoimmune Gastritis in Individuals Undergoing Medical Checkups in Japan. Intern Med 2019; 58:1817-1823. [PMID: 30918182 PMCID: PMC6663548 DOI: 10.2169/internalmedicine.2292-18] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective Based on both endoscopic findings and serum auto-antibody levels, we determined the prevalence of autoimmune gastritis (AIG), which has not been previously reported, in individuals who underwent health checkup examinations in Japan. Methods At total of 6,739 subjects (4,288 males, 2,451 females; mean age 52.1 years) underwent an upper gastrointestinal endoscopic examination as part of an annual medical checkup. Those suspected to have AIG based on endoscopic evidence of proximal-predominant gastric mucosal atrophy were further examined for the presence of anti-parietal cells and anti-intrinsic factor antibodies, with a final diagnosis of AIG made in cases found to be positive for either or both of those factors. Results Of the 6,739 examined subjects, 46 were suspected to have AIG based on the endoscopic findings, of whom 33 were finally diagnosed with AIG, for an overall prevalence 0.49% (females 0.65%, males 0.40%). Seven with AIG also had thyroid disease, including Hashimoto's and Basedow disease, while none with AIG showed anemia in blood test findings. The prevalence of AIG was not different regardless of the H. pylori infection status (negative, positive, post-eradicated). Conclusion In individuals who underwent an upper gastrointestinal endoscopic examination as part of an annual checkup in Japan, the prevalence of AIG was 0.49%. We concluded that it is not uncommon for asymptomatic and healthy individuals to have AIG, and propose that additional studies are needed to clarify its prevalence as well as to establish the criteria used for diagnosis.
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Affiliation(s)
- Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Harumi Fujihara
- Clinical Laboratory, Shimane Environment and Health Public Corporation, Japan
| | - Takashi Toda
- Clinical Laboratory, Shimane Environment and Health Public Corporation, Japan
| | - Shigeru Takaki
- Clinical Laboratory, Shimane Environment and Health Public Corporation, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Lee SY. Helicobacter pylori Infection and the Kyoto Classification of Gastritis. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2019. [DOI: 10.7704/kjhugr.2019.19.2.81] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Uno Y. Prevention of gastric cancer by Helicobacter pylori eradication: A review from Japan. Cancer Med 2019; 8:3992-4000. [PMID: 31119891 PMCID: PMC6639173 DOI: 10.1002/cam4.2277] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/10/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023] Open
Abstract
Japan introduced a Helicobacter pylori eradication therapy strategy in 2013, with the aim of decreasing the number of gastric cancer‐related death, the number of new cases of gastric cancer, and associated medical costs. Five years have passed since then, but no reduction in the annual number of gastric cancer has been observed. In addition, it was suggested that the number of deaths due to gastric cancer could be reduced to 30,000 a year by 2020, but the annual death toll in 2017 remained at more than 45,000. Based on the above evidence, it was examined whether it was possible to reach the target value based on the data from the last 5 years. The number of deaths per year in 2020 is predicted to be more than 40,000, which is clearly different from the target value. Logically, the effect of the strategy might appear by 2023. However, there is a possibility that the risk of gastric cancer may increase in some populations due to the influence of proton pump inhibitors and dysbiosis in the gastric microbiome. To solve these problems, combined therapy with PPIs and aspirin for patients after H pylori eradication should be considered.
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Kono Y, Kanzaki H, Tsuzuki T, Takatani M, Nasu J, Kawai D, Takenaka R, Tanaka T, Iwamuro M, Kawano S, Kawahara Y, Fujiwara T, Okada H. A multicenter observational study on the clinicopathological features of gastric cancer in young patients. J Gastroenterol 2019; 54:419-426. [PMID: 30374622 DOI: 10.1007/s00535-018-1525-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/23/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The details of gastric cancer in young patients remain unclear because of the low prevalence of the disease. This study aimed to clarify the clinicopathological features and prognosis of gastric cancer in young patients. METHODS From January 2007 to January 2016, patients in their 20s and 30s who were diagnosed with primary gastric cancer at 4 hospitals were enrolled. Their clinical characteristics and prognosis were evaluated. RESULTS The total number of patients was 72. The median age was 36 years, and the ratio of males to females was 1:1. The dominant histological type was undifferentiated type (66/72, 92%). Helicobacter pylori (H. pylori) was positive in 81% (54/67). Although there were some asymptomatic patients in stages I-III, all stage IV patients had some clinical symptoms at the diagnosis. The percentage of stage IV was significantly higher in patients in their 20s than in those in their 30s (75% vs. 25%, P < 0.001). The Kaplan-Meier method showed that the overall survival of patients in their 20s was significantly lower than that of patients in their 30s (P = 0.037). CONCLUSIONS A high rate of H. pylori infection was revealed in young gastric cancer patients. The patients in their 20s had a worse prognosis than those in their 30s. We should consider examining the H. pylori infection status for young patients as well as older patients to identify high-risk populations.
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Affiliation(s)
- Yoshiyasu Kono
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Masahiro Takatani
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Junichirou Nasu
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Daisuke Kawai
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoshiro Kawahara
- Department of Endoscopy, Okayama University Hospital, Okayama, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Abstract
Objective The recently reported endoscopic finding of black spots is defined as black pigmentation in gastric mucosa. We attempted to clarify the relationship between the Helicobacter pylori infection status and black spot occurrence. Methods The study subjects were 1,600 individuals who underwent an annual medical checkup and whose H. pylori status could be determined. Upper endoscopic examinations were performed in all, and the presence of black spots in the stomach as well as the degree of gastric mucosal atrophy were determined. Results Among the 1,600 enrolled subjects, 784 underwent eradication for H. pylori, of whom 144 were originally H. pylori-positive and 672 H. pylori-negative. Black spots in the stomach were observed in 156 (9.8%). The rate of prevalence of black spots in the H. pylori-positive and H. pylori-negative subjects was 2.1% and 1.5%, respectively, while that in subjects after undergoing eradication of H. pylori was 18.2%. A multiple logistic regression analysis demonstrated that an older age and post-eradication status were significant factors for black spot occurrence, while proton pump inhibitor treatment showed a tendency to be a risk factor. In subjects with post-eradication status, a higher grade of gastric mucosal atrophy was a significant risk factor for the occurrence of black spots. Conclusion H. pylori post-eradication status and an older age were significant factors related to the appearance of black spots, and a higher grade of gastric mucosal atrophy was also a significant risk factor in subjects who had undergone successful eradication.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Takumi Notsu
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Han HS, Lee SY, Oh SY, Moon HW, Cho H, Kim JH. Correlations of the Gastric and Duodenal Microbiota with Histological, Endoscopic, and Symptomatic Gastritis. J Clin Med 2019; 8:E312. [PMID: 30841591 PMCID: PMC6462939 DOI: 10.3390/jcm8030312] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 12/19/2022] Open
Abstract
Mucosal inflammation is characterized by neutrophil and mononuclear cell infiltration. This study aimed to determine the gastric and duodenal microbiota associated with histological, endoscopic, and symptomatic gastritis. Dyspeptic adults who presented for evaluation were included. Subjects with either comorbidities or recent drug intake were excluded. Three endoscopic biopsies were obtained from the antrum, body, and duodenum. Next-generation sequencing for 16S ribosomal RNA V1⁻V2 hypervariable regions was performed. The correlation between the composition of microbiota and the degree of inflammatory cell infiltration, endoscopic findings, and Patient Assessment of Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) score was analyzed. In 98 included subjects, microbial communities in the antrum and body showed Bray⁻Curtis similarity; however, those in the duodenum showed dissimilarity. Histological and endoscopic gastritis was associated with the abundance of Helicobacter pylori and that of commensal bacteria in the stomach. The abundances of Variovorax paradoxus and Porphyromonas gingivalis were correlated with histological gastritis, but not with endoscopic or symptomatic gastritis. The total PAGI-SYM score showed a stronger correlation with the duodenal microbiota (Prevotella nanceiensis and Alloprevotella rava) than with the gastric microbiota (H. pylori, Neisseria elongate, and Corynebacterium segmentosum). Different correlations of the gastric and duodenal microbiota with histological, endoscopic, and symptomatic gastritis were observed for the first time at the species level. H. pylori-negative gastritis is not associated with endoscopic or symptomatic gastritis. Only H. pylori-induced endoscopic gastritis requires gastric cancer surveillance. Owing to the weak correlation with H. pylori, symptomatic gastritis should be assessed separately from histological and endoscopic gastritis.
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Affiliation(s)
- Hye Seung Han
- Department of Pathology, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Sun-Young Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Seo Young Oh
- Department of Pathology, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Hee Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Korea.
| | - Hyunseok Cho
- R&D Center, BioCore. Co. Ltd., Seoul 08511, Korea.
| | - Ji-Hoon Kim
- R&D Center, BioCore. Co. Ltd., Seoul 08511, Korea.
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Nagata N, Ishii N, Kaise M, Shimbo T, Sakurai T, Akiyama J, Uemura N. Long-term recurrent bleeding risk after endoscopic therapy for definitive colonic diverticular bleeding: band ligation versus clipping. Gastrointest Endosc 2018; 88:841-853.e4. [PMID: 30036505 DOI: 10.1016/j.gie.2018.07.018] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 07/14/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Very few prospective studies with over 100 samples have evaluated the long-term outcomes of endoscopic therapy for colonic diverticular bleeding (CDB). This study sought to elucidate the recurrent bleeding risk of endoscopic band ligation versus clipping for definitive CDB based on stigmata of recent hemorrhage (SRH). METHODS Patients emergently hospitalized for acute lower GI bleeding and examined by high-resolution colonoscopy were enrolled. Better visualization of SRH from a diverticulum was obtained using a water-jet device. Endoscopic band ligation or clipping was performed as first-line treatment, and patients were prospectively followed after discharge. RESULTS No statistical difference was found between the ligation (n = 61) and clipping (n = 47) groups in baseline characteristics or follow-up period. The probability of 1-year recurrent bleeding was 11.5% in the ligation group versus 37.0% in the clipping group (P = .018). No patients required surgery or experienced perforation. One patient in the ligation group experienced diverticulitis the next day. In patients with recurrent bleeding within 7 days, the recurrent bleeding site was the same diverticulum, and ulceration was found in the ligation group on repeat colonoscopy. In patients with recurrent bleeding after 2 months, repeat colonoscopy identified that the recurrent bleeding site was different, and scar formation was seen in the ligation group. The left side of the colon was an independent predictor for recurrent bleeding in the ligation group but not in the clipping group. CONCLUSIONS Band ligation for definitive CDB has better outcomes than clipping during long-term follow-up after endoscopic therapy, probably because of complete elimination of the diverticulum. CDB can recur at the same diverticulum in the short term but at a different diverticulum in the long term.
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Affiliation(s)
- Naoyoshi Nagata
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoki Ishii
- Gastroenterology Division, Koga Hospital, Koga, Japan; Gastroenterology Division, St. Luke's International Hospital, Tokyo, Japan
| | - Mitsuru Kaise
- Gastroenterology Division, Nippon Medical School, Tokyo, Japan
| | - Takuro Shimbo
- Department of Internal Medicine, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Toshiyuki Sakurai
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan; Department of Gastroentegology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junichi Akiyama
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naomi Uemura
- Department of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
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Adachi K, Mishiro T, Okimoto E, Kinoshita Y. Influence of the Degree of Gastric Mucosal Atrophy on the Serum Lipid Levels Before and After the Eradication of Helicobacter pylori Infection. Intern Med 2018; 57:3067-3073. [PMID: 29877271 PMCID: PMC6262702 DOI: 10.2169/internalmedicine.1074-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective To clarify the influence of the degree of gastric mucosal atrophy on the serum lipid levels before and after the eradication of Helicobacter pylori infection. Methods The subjects were individuals who underwent an annual detailed medical checkup. Serum anti-H. pylori IgG antibody detection and upper endoscopic examinations were performed in all subjects. Gastric mucosal atrophy was evaluated by the classification of Kimura and Takemoto. The serum levels of total cholesterol, high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), LDLC/HDLC ratio, and triglycerides were compared among the different degrees of gastric mucosal atrophy in H. pylori-positive subjects. In addition, changes in those serum lipid levels during a two-year period were compared among H. pylori post-eradication cases that showed different degrees of gastric mucosal atrophy prior to eradication. Results In subjects with higher degrees of gastric mucosal atrophy, the serum levels of total cholesterol, LDLC, and triglycerides were elevated. Furthermore, the LDLC/HDLC ratio in subjects with moderate and severe grades of gastric mucosal atrophy was significantly higher than in subjects with mild atrophy. In subjects with higher degrees of gastric mucosal atrophy, the serum level of LDLC and the LDLC/HDLC ratio were decreased following eradication of H. pylori. Conclusion Lipid metabolism is influenced by the degree of gastric mucosal atrophy present before the eradication of H. pylori, and the favorable effects of such eradication are significant in patients with higher degrees of atrophy.
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Affiliation(s)
- Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Tomoko Mishiro
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Eiko Okimoto
- Health Center, Shimane Environment and Health Public Corporation, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan
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Kim DB, Chung WC. Accuracy of Endoscopic Diagnosis of Mild Atrophic Gastritis with Helicobacter pylori Infection. Clin Endosc 2018; 51:310-312. [PMID: 30001615 PMCID: PMC6078936 DOI: 10.5946/ce.2018.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 01/07/2023] Open
Affiliation(s)
- Dae Bum Kim
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Woo Chul Chung
- Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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