Background and Aims
Limited studies have evaluated the risk factors of gastric cancer (GC) after eradication
of Helicobacter pylori (H pylori) using endoscopic findings. We aimed to investigate GC detection-related endoscopic
findings after eradication of H pylori using linked color imaging (LCI), a novel image-enhanced endoscopy.
Methods
This single-center, cross-sectional study evaluated background mucosa-associated endoscopic
findings described in the Kyoto classification of gastritis in patients with newly
detected GC after eradication of H pylori (CA group, n = 109) and those without GC (NC group, n = 85) using white-light imaging
(WLI) and LCI.
Results
Severe atrophy and map-like redness were significantly more frequent in the CA group
than in the NC group using WLI (79.8% vs 63.5%, P = .01; 61.5% vs 37.7%, P = .001, respectively) and LCI (79.8% vs 63.5%, P = .01; 78.0% vs 45.9%, P < .0001, respectively). Regular arrangement of collecting venules (RAC) was significantly
less frequent in the CA group than in the NC group using WLI (40.3% vs 64.7%, P = .0009) and LCI (37.6% vs 62.4%, P = .0006). Map-like redness was an independent positive risk factor (WLI: odds ratio
[OR], 2.05; 95% confidence interval [CI], 1.09-3.87; P = .03; LCI: OR, 3.62; 95% CI, 1.88-6.97; P < .001), whereas RAC was an independent negative risk factor (WLI: OR, 0.42; 95%
CI, 0.21-0.82; P = .01; LCI: OR, 0.46; 95% CI, 0.23-0.93, P = .03) for detection of GC after eradication of H pylori.
Conclusions
Map-like redness, which was identified more frequently using LCI than WLI, and the
absence of RAC were associated with detection of GC after eradication of H pylori.
Abbreviations:
CI (confidence interval), GC (gastric cancer), LCI (linked color imaging), OR (odds ratio), RAC (regular arrangement of collecting venules), WLI (white-light imaging)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 09, 2019
Accepted:
June 27,
2019
Received:
April 9,
2019
Footnotes
DISCLOSURE: Dr Yoshida received a research grant from Fujifilm Medical (J082003006). Dr Handa has been paid lecture fees by Daiichisankyo. Dr Naito received a scholarship fund from EA Pharma and a collaboration research fund from Fujifilm Medical, and has been paid lecture fees by Janssen Pharma, Mylan EPD, Takeda Pharma, Mochida Pharma, EA Pharma, Otsuka Pharma, Astellas Pharma, and Miyarisan Pharma. Dr Itoh was affiliated with a department that was partially funded by Fujifilm Medical (J082003006). The research was partly funded by these funds. Neither the funding agency nor any outside organization has participated in the study design or has any conflict of interest. All other authors disclosed no financial relationships relevant to this publication.
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© 2019 by the American Society for Gastrointestinal Endoscopy
