The gastric mucosal features of Helicobacter pylori associated gastritis evaluated by high - resolution magnifying endoscopy / 中华消化内镜杂志

ABSTRACT

Objective To investigate the gastric mucosal characteristics of Helicobacter pylori(Hp)-associated gastritis under high-resolution magnifying endoscopy. Methods Fujinon EG 485 ZH 850k CCD high-resolution electronic magnifying endoscopy was performed. Fifty patients were inspected by regular endoscopy with high-resolution magnifying function. Particular inspection was given on the collecting venules, the pit patterns of the gastric antrum and gastric body. Four pieces of biopsy specimen were taken, 1 each in antrum and body for RUT and the other two for pathologic examination as well as W-S stain. Both of the W-S stain and RUT being positive were confirmed as Hp infection. The Hp-positive patients received the triple therapy. Endoscopy with biopsies was repeated 4 weeks after the course of eradication treatment ended. The results were assessed by SPSS 8. 0 statistical package. Results Twenty-six patients were Hp-positive and 24 patients Hp-negative. In comparing with the results of W-S stain and RUT , the high-resolution magnifying endoscopy features and regular endoscopy findings had different outcomes. The sensitivity was 69. 23% Vs 34. 62% ; the accuracy 78.00% Vs 58. 00% respectively; the positive likelihood ratio and the negative likelihood ratio were 5. 54 Vs 2. 08 and 0. 35 Vs 0. 78 respectively. The Kappa value in high-resolution magnifying endoscopy was 0.563 whereas in regular endoscopy was 0. 176. Conclusions The advantage of high-resolution magnifying endoscopy relies on its ability to observe the fine gastric mucosal patterns. The gastric mucosal features of Hp-associated gastritis can be described as followings collecting venules are irregular or disappeared; the gastric pits are enlarged or reddened, the sulciolar are deepened. Compared with regular endoscopy, the high-resolution magnifying endoscopy is better in sensitivity, accuracy and likelihood ratio. A high degree of interobserver agreement was obtained with the Kappa value. The pathologic findings get better soon after the eradication therapy, while the endoscopic changes are not prominent.