Yada Tomoyuki, Itakura Yoshiyuki, Watanabe Ryo, Odaka Keita, Yagi Toyokazu, Ikegami Yurika, Sekine Katsunori, Uemura Naomi
Division of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba Japan.
Division of Gastroenterology Matsue Red Cross Hospital Shimane Japan.
DEN Open. 2022 Dec 22;3(1):e200. doi: 10.1002/deo2.200. eCollection 2023 Apr.
During esophagogastroduodenoscopy, a red linear scrape-like appearance with white deposits sometimes appears on the gastric mucosa at the lower greater curvature of the gastric body, a finding we named the "scratch sign." We aimed to clarify the clinical significance of this new endoscopic finding in the endoscopic evaluation of the infection status.
Among patients who underwent esophagogastroduodenoscopy at our hospital between October 2016 and June 2017, 437 patients were included in the study. We first examined the overall scratch sign positivity rate, and then this was compared according to the infection status. Subsequently, other variables were compared and examined between the positive and negative scratch sign groups.
Overall, 437 patients were included in the analysis. The scratch sign was observed in 1.4% of 71 patients with current infections, 26.9% of 290 patients with past infections, and 31.6% of 76 uninfected patients. In the multivariate analysis, -negative, severe gastric mucosal atrophy, and acid secretion depressant were independent factors that significantly affected the appearance of the scratch sign.
A novel endoscopic finding, the scratch sign, was found to be a good endoscopic predictor of -negative gastric mucosa. Furthermore, combined with atrophic changes and xanthomas that persisted after eradication, these findings were found to be useful in accurately diagnosing past-infected gastric mucosa endoscopically.
在食管胃十二指肠镜检查期间，胃体大弯下部的胃黏膜上有时会出现伴有白色沉积物的红色线状刮痕样外观，我们将这一发现命名为“刮痕征”。我们旨在阐明这一新的内镜检查发现在内镜评估感染状态中的临床意义。
在2016年10月至2017年6月期间在我院接受食管胃十二指肠镜检查的患者中，437例患者纳入本研究。我们首先检查了总体刮痕征阳性率，然后根据感染状态进行比较。随后，在刮痕征阳性和阴性组之间比较并检查其他变量。
总体而言，437例患者纳入分析。在71例现症感染患者中，1.4%观察到刮痕征；在290例既往感染患者中，26.9%观察到刮痕征；在76例未感染患者中，31.6%观察到刮痕征。在多变量分析中，阴性、严重胃黏膜萎缩和抑酸剂是显著影响刮痕征出现的独立因素。
一种新的内镜检查发现，即刮痕征，被发现是阴性胃黏膜的良好内镜预测指标。此外，结合根除后持续存在的萎缩性改变和黄色瘤，这些发现被认为有助于在内镜下准确诊断既往感染的胃黏膜。
