Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Dig Endosc. 2015 Jul;27(5):582-9. doi: 10.1111/den.12427. Epub 2015 Jan 30.
Gastric acidic abnormalities are related to various types of diseases in Helicobacter pylori (H. pylori) infection status. However, no studies have shown correlations between many tiny endoscopic findings and the acid secretion level simultaneously. In the present study, we investigated predictive tiny endoscopic findings of hyperchlorhydria and hypochlorhydria.
A total of 223 subjects without organic diseases who underwent esophagogastroduodenoscopy and endoscopic gastrin test (EGT) for estimating gastrin-stimulated gastric acid secretory response between 1999 and 2012 at our institution were retrospectively analyzed. Two blinded expert endoscopists reviewed the images independently and recorded the endoscopic findings.
According to the EGT values, the enrolled subjects were categorized into hyperchlorhydria, normal acid secretion, and hypochlorhydria groups. In all subjects, hematin (odds ratio [95% confidence interval] = 3.32 [1.40-7.84]) and antral erosion(2.88 [1.24-6.70]) were the predictive endoscopic findings for hyperchlorhydria, and swelling of areae gastricae (14.4 [5.74-36.1]) and open-type atrophy (15.1 [7.35-31.1]) were those for hypochlorhydria. In addition, the predictive endoscopic findings for hyperchlorhydria differed according to the H. pylori infection status, hematin in H. pylori-positive subjects and antral erosion in H. pylori-negative subjects, in contrast to those for hypochlorhydria, which were the same irrespective of the H. pylori infection status.
We could predict the acid secretion status based on the endoscopic findings regardless of H. pylori infection status, which would be of some help for evaluating the risk for acid-related diseases.
胃酸异常与幽门螺杆菌（H. pylori）感染状态下的各种疾病有关。然而，目前尚无研究同时显示许多微小内镜表现与胃酸分泌水平之间的相关性。本研究旨在探讨胃酸分泌过多和胃酸分泌不足的预测性微小内镜表现。
回顾性分析了 1999 年至 2012 年间在我院接受食管胃十二指肠镜检查和内镜胃泌素试验（EGT）以评估胃泌素刺激胃酸分泌反应的 223 例无器质性疾病的患者。两名盲法内镜专家独立回顾图像并记录内镜发现。
根据 EGT 值，将纳入的患者分为胃酸分泌过多组、正常胃酸分泌组和胃酸分泌不足组。在所有患者中，胃底腺出血（比值比[95%置信区间] = 3.32 [1.40-7.84]）和胃窦部糜烂（2.88 [1.24-6.70]）是胃酸分泌过多的预测性内镜表现，胃底腺肿胀（14.4 [5.74-36.1]）和开放型萎缩（15.1 [7.35-31.1]）是胃酸分泌不足的预测性内镜表现。此外，胃酸分泌过多的预测性内镜表现因 H. pylori 感染状态而异，H. pylori 阳性患者中为胃底腺出血，H. pylori 阴性患者中为胃窦部糜烂，而胃酸分泌不足的预测性内镜表现则与 H. pylori 感染状态无关。
我们可以根据内镜发现预测胃酸分泌状态，而无需考虑 H. pylori 感染状态，这有助于评估与酸相关疾病的风险。
