Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show-Chwan Memorial Hospital, No. 6, Lugong Rd., Lugang Township, Changhua County 505, Taiwan, China.
World J Gastroenterol. 2010 Jan 28;16(4):496-500. doi: 10.3748/wjg.v16.i4.496.
To identify the mucosal patterns of Helicobacter pylori (H. pylori)-related gastritis in the gastric corpus using standard endoscopy and to evaluate their reproducibility.
A total of 112 consecutive patients underwent upper gastrointestinal endoscopy. The endoscopists classified the endoscopic findings into 4 patterns. In the second part of the study, 90 images were shown to 3 endoscopists in order to evaluate the inter-observer and intra-observer variability in image assessment.
The mucosal patterns of the gastric body were categorized into 4 types. Type 1 pattern was defined as cleft-like appearance, type 2 as regular arrangement of red dots, type 3 pattern as the mosaic mucosal pattern and type 4 pattern as the mosaic pattern with a focal area of hyperemia. Type 1 and type 2 mucosal patterns were statistically significant in predicting H. pylori-negative status as compared with other mucosal types (chi(2) = 12.79 and 61.25 respectively, P < 0.01). Type 3 and type 4 mucosal patterns were statistically significant in predicting a H. pylori-positive status as compared with other mucosal types (chi(2) = 21.22 and 11.02 respectively, P < 0.01). Furthermore, the sensitivity, specificity, positive and negative predictive values of type 3 plus type 4 patterns for predicting H. pylori-positive gastric mucosa were 100%, 86%, 94%, and 100%, respectively. The mean kappa values for inter- and intra-observer agreement in assessing the various endoscopic patterns were 0.808 (95% CI, 0.678-0.938) and 0.826 (95% CI, 0.727-0.925) respectively.
Our study suggests that mucosal patterns in H. pylori-infected gastric mucosa without atrophy can be reliably identified using standard endoscopy in the gastric corpus.
使用标准内镜确定胃体部幽门螺杆菌（H. pylori）相关胃炎的黏膜模式，并评估其可重复性。
对 112 例连续患者进行上消化道内镜检查。内镜医师将内镜检查结果分为 4 种模式。在研究的第二部分，将 90 张图像展示给 3 名内镜医师，以评估图像评估的观察者间和观察者内变异性。
胃体的黏膜模式分为 4 种类型。1 型模式定义为裂隙样外观，2 型为规则排列的红点，3 型为马赛克黏膜模式，4 型为马赛克伴局灶性充血模式。与其他黏膜类型相比，1 型和 2 型黏膜模式在预测 H. pylori 阴性状态方面具有统计学意义（卡方分别为 12.79 和 61.25，P < 0.01）。与其他黏膜类型相比，3 型和 4 型黏膜模式在预测 H. pylori 阳性状态方面具有统计学意义（卡方分别为 21.22 和 11.02，P < 0.01）。此外，3 型加 4 型模式预测 H. pylori 阳性胃黏膜的敏感性、特异性、阳性和阴性预测值分别为 100%、86%、94%和 100%。评估各种内镜模式的观察者间和观察者内一致性的平均 Kappa 值分别为 0.808（95%可信区间，0.678-0.938）和 0.826（95%可信区间，0.727-0.925）。
我们的研究表明，使用标准内镜可以可靠地识别无萎缩的 H. pylori 感染胃黏膜的黏膜模式。
