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在临床实践中诊断的特征性内镜发现。

Characteristic endoscopic findings in diagnosis in clinical practice.

机构信息

Division of Genome-Wide Infectious Diseases, Research Center for GLOBAL and LOCAL Infectious Disease, Oita University, Yufu, Japan.

Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

出版信息

Expert Rev Gastroenterol Hepatol. 2024 Aug;18(8):457-472. doi: 10.1080/17474124.2024.2395317. Epub 2024 Aug 22.

Abstract

INTRODUCTION

is a major risk factor for gastric cancer. In addition to eradication therapy, early-phase detection of gastric cancer through screening programs using high-vision endoscopy is also widely known to reduce mortality. Although European and US guidelines recommend evaluation of atrophy and intestinal metaplasia by high-vision endoscopy and pathological findings, the guideline used in Japan - the Kyoto classification of gastritis - is based on endoscopic evaluation, and recommends the grading of risk factors. This system requires classification into three endoscopic groups: -negative, previous infection (inactive gastritis), and current infection (active gastritis). Major endoscopic findings in active gastritis are diffuse redness, enlarged folds, nodularity, mucosal swelling, and sticky mucus, while those in -related gastritis - irrespective of active or inactive status - are atrophy, intestinal metaplasia, and xanthoma.

AREAS COVERED

This review describes the endoscopic characteristics of current infection, and how characteristic endoscopic findings should be evaluated.

EXPERT OPINION

Although the correct evaluation of endoscopic findings related to remains necessary, if findings of possible infection are observed, it is important to diagnose infection by detection methods with high sensitivity and specificity, including the stool antigen test and urea breath test.

摘要

简介

幽门螺杆菌是胃癌的主要危险因素。除了根除疗法外,通过使用高倍视野内窥镜进行胃癌早期筛查计划也被广泛认为可以降低死亡率。尽管欧洲和美国的指南建议通过高倍视野内窥镜和病理发现评估萎缩和肠化生,但在日本使用的指南——胃炎京都分类——是基于内镜评估的,并建议对危险因素进行分级。该系统要求分为三组:阴性、既往感染(非活动性胃炎)和当前感染(活动性胃炎)。活动性胃炎的主要内镜表现为弥漫性发红、皱襞增大、结节、黏膜肿胀和粘性黏液,而与幽门螺杆菌相关的胃炎——无论活动性或非活动性——的特征是萎缩、肠化生和黄斑瘤。

涵盖领域

本文综述了当前幽门螺杆菌感染的内镜特征,以及如何评估特征性内镜发现。

专家意见

尽管正确评估与幽门螺杆菌相关的内镜发现仍然是必要的,但如果观察到可能感染的内镜发现,重要的是通过包括粪便抗原检测和尿素呼气试验在内的具有高灵敏度和特异性的检测方法来诊断感染。

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