Seo Jun-Young, Cho Hyo-Jin, Park Sang Jong, Lee Ah Young, Kim Sang-Jung, Ahn Ji Yong
Department of Gastroenterology, DMC Bundang Jesaeng General Hospital, Seongnam, Korea.
Department of Gastroenterology, Asan Medical Center, Ulsan University of College of Medicine, Seoul, Korea.
Korean J Helicobacter Up Gastrointest Res. 2023 Sep;23(3):197-206. doi: 10.7704/kjhugr.2023.0029. Epub 2023 Aug 30.
BACKGROUND/AIMS: Identification of infection status is necessary as is associated with gastric malignancy. Recently, a red linear scrape-like appearance on the gastric mucosa, called the "scratch sign," was reported to be associated with -negative gastric mucosal status. Herein, we aimed to validate the association between the scratch sign and infection status.
The data of patients who underwent screening endoscopy at Bundang Jesaeng General Hospital between March 2023 and April 2023 were reviewed. Patients were classified as having an current infection or non-infection status based on the results of rapid urease tests. Patients who had undergone eradication therapy were excluded. Endoscopic features of the gastric mucosa were assessed using the Kyoto classification of gastritis.
The scratch sign appeared more frequently in patients with non-infection than in those with current infection status (32.7% vs. 10.6%, respectively; <0.001). Multivariate analysis showed that only the presence of sticky mucus was significantly associated with the presence of the scratch sign. Patient without the scratch sign had a higher prevalence of open-type atrophy, intestinal metaplasia, enlarged folds, and diffuse redness, which reflected a higher Kyoto score.
Presence of the gastric mucosal scratch sign, a novel endoscopic marker, is indicative of -negative status and appears to be inversely correlated with the presence of sticky mucus. In addition to the Kyoto classification of gastritis, detection of the scratch sign may facilitate identification of the infection status.
背景/目的：识别幽门螺杆菌感染状态很有必要，因为其与胃恶性肿瘤有关。最近，有报道称胃黏膜上一种红色线性刮痕样外观，即“刮痕征”，与幽门螺杆菌阴性的胃黏膜状态有关。在此，我们旨在验证刮痕征与幽门螺杆菌感染状态之间的关联。
回顾了2023年3月至2023年4月在盆唐耶稣总医院接受筛查内镜检查的患者数据。根据快速尿素酶试验结果，将患者分为幽门螺杆菌现感染或未感染状态。排除接受过幽门螺杆菌根除治疗的患者。使用胃炎京都分类法评估胃黏膜的内镜特征。
未感染患者中刮痕征出现的频率高于现感染患者（分别为32.7%和10.6%；P<0.001）。多因素分析显示，只有粘性黏液的存在与刮痕征的存在显著相关。没有刮痕征的患者开放性萎缩、肠化生、皱襞增大和弥漫性发红的患病率更高，这反映出京都评分更高。
胃黏膜刮痕征作为一种新的内镜标志物，提示幽门螺杆菌阴性状态，且似乎与粘性黏液的存在呈负相关。除胃炎京都分类法外，刮痕征的检测可能有助于识别幽门螺杆菌感染状态。
