Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3597-3606
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3597
Clinically significant endoscopic findings in patients of dyspepsia with no warning symptoms: A cross-sectional study
Li-Qi Mao, Shuang-Shuang Wang, Yan-Lin Zhou, Lin Chen, Lei-Min Yu, Meng Li, Bin Lv
Li-Qi Mao, Shuang-Shuang Wang, Yan-Lin Zhou, Lin Chen, Lei-Min Yu, Meng Li, Bin Lv, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Shuang-Shuang Wang, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
Lei-Min Yu, Department of Gastroenterology, Guangxing Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310007, Zhejiang Province, China
Author contributions: Mao LQ, Wang SS and Lv B designed the research study; Mao LQ, Wang SS, Zhou YL, Chen L, Yu LM and Li M performed the research; Mao LQ and Wang SS analyzed the data; Mao LQ, Wang SS and Lv B wrote the manuscript.
Supported by the National Natural Science Foundation of China, No. 81770535.
Institutional review board statement: The study was reviewed and approved by the ethics committee of the first affiliated hospital of Zhejiang Chinese Medical University (Approval No. 2017-ZX-052-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Lv, MM, Chief Doctor, Professor, Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. lvbin@medmail.com.cn
Received: January 11, 2021
Peer-review started: January 11, 2021
First decision: February 23, 2021
Revised: February 26, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: May 26, 2021
ARTICLE HIGHLIGHTS
Research background

Dyspepsia is a common clinical disorder. No studies have evaluated the diagnostic value of endoscopy in patients with no warning symptoms according to the Rome IV criteria.

Research motivation

Many studies have used warning symptoms to predict important endoscopic findings in patients with dyspepsia. However, there remains an uncertainty regarding the best initial management strategy for those patients with no warning features.

Research objectives

To evaluate the diagnostic value of endoscopy in dyspeptic patients with no warning symptoms.

Research methods

We performed a cross-sectional study of dyspeptic patients with no warning symptoms from April 2018 to February 2019.

Research results

The incidence of malignancy (0.9%) among dyspeptic patients with no warning symptoms was high. Moreover, male gender, body mass index > 25, epigastric pain and Helicobacter pylori infection were independently associated with significant endoscopic findings.

Research conclusions

According to the Rome IV standard, endoscopy is of high diagnostic value for dyspeptic patients with no warning symptoms in China. Dyspeptic patients should undergo gastroscopy regardless of the presence or absence of warning symptoms.

Research perspectives

Gastroscopy should be the initial management strategy for dyspeptic Chinese patients even in the absence of warning features. In the future, more controlled studies from multicenter samples will be needed to confirm this.