Sato Hiroki, Inoue Haruhiro, Ikeda Haruo, Sato Chiaki, Phlanusittepha Chainarong, Hayee Bu'Hussain, Santi Esperanza Grace R, Kobayashi Yasutoshi, Kudo Shin-Ei
Hiroki Sato, Haruhiro Inoue, Haruo Ikeda, Chiaki Sato, Chainarong Phlanusittepha, Shin-ei Kudo, Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama 224-8503, Japan.
World J Gastroenterol. 2015 Apr 28;21(16):5002-8. doi: 10.3748/wjg.v21.i16.5002.
To study the ability of endocytoscopy to identify normal gastric mucosa and to exclude Helicobacter pylori (H. pylori) infection.
Endocytoscopic examination of the gastric corpus and antrum was performed in 70 consecutive patients. Target biopsy specimens were also obtained from the assessed region and multiple H. pylori tests were performed. The normal endocytoscopy patterns of the corpus and antrum were divided into the normal pit-dominant type (n-Pit) or the normal papilla-dominant type (n-Pap), respectively characterized as either regular pits with capillary networks or round, smooth papillary structures with spiral capillaries. On the other hand, normal mucosa was defined as mucosa not demonstrating histological abnormalities, including inflammation and atrophy.
The sensitivity and specificity of n-Pit for normal mucosa in the gastric corpus were 94.4% and 97.1%, respectively, whereas those of n-Pap for normal mucosa in the antrum were 92.0% and 86.7%, respectively. The positive predictive values of n-Pit and n-Pap for H. pylori-negative tissue were 88.6% and 93.1%, respectively, and their negative predictive values for H. pylori-negative tissues were 42.9% and 41.5%, respectively. The inter-observer agreement for determining n-Pit and n-Pap for normal mucosa were 0.857 and 0.769, respectively, which is considered reliable.
N-Pit and n-Pap, seen using EC, are considered useful predictors of normal mucosa and the absence of H. pylori infection.
研究内镜直视下观察法识别正常胃黏膜及排除幽门螺杆菌（H. pylori）感染的能力。
对70例连续患者进行胃体和胃窦的内镜直视下观察检查。还从评估区域获取目标活检标本，并进行多次幽门螺杆菌检测。胃体和胃窦的正常内镜直视下观察模式分别分为正常凹坑为主型（n-Pit）或正常乳头为主型（n-Pap），其特征分别为具有毛细血管网的规则凹坑或具有螺旋状毛细血管的圆形、光滑乳头结构。另一方面，正常黏膜定义为未显示组织学异常（包括炎症和萎缩）的黏膜。
胃体中n-Pit对正常黏膜的敏感性和特异性分别为94.4%和97.1%，而胃窦中n-Pap对正常黏膜的敏感性和特异性分别为92.0%和86.7%。n-Pit和n-Pap对幽门螺杆菌阴性组织的阳性预测值分别为88.6%和93.1%，它们对幽门螺杆菌阴性组织的阴性预测值分别为42.9%和41.5%。观察者间对确定正常黏膜的n-Pit和n-Pap的一致性分别为0.857和0.769，被认为是可靠的。
内镜直视下观察法所见的n-Pit和n-Pap被认为是正常黏膜和无幽门螺杆菌感染的有用预测指标。
