Assessment of the severity helicobacter pylori gastritis by narrow band imaging endoscopy: a validation study

Authors

1 Department of Internal Medicine, Faculty of Medicine, Al-Azhar University

2 Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 Department of internal medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt,

Abstract

Background: Chronic Helicobacter pylori (H. pylori) infected patients are at an increased risk for developing non-cardia gastric cancer. New Endoscopic modalities could help detection of those patients at high-risk for gastric cancer. Aim: Our goal was to evaluate the precision of conventional narrow band imaging (C-NBI) in determining the degree of gastric atrophy and H. pylori-related symptoms. Patients and Methods: Using the modified Sydney classification, the gastric mucosal pattern at the lesser curvature of the lower gastric body was first detected using C-NBI. Target samples were then taken for histological evaluation. Furthermore, endoscopic evaluation of the stomach mucosal atrophy utilizing the Kimura-Takemoto classification. Results: The mean age of the 88 individuals with gastritis associated with H. pylori was 36.9 ± 15.5 years, 51 (58%) of them were female and 37 (42%) were male. There were three types of pit patterns found: elongated (46.5%), large rounded (20.5%) and tiny rounded (33%). The risk of mild gastritis was considerably higher in patients with an extended pit pattern (P = 0.005). There was a substantial correlation found between the histological diagnosis of gastric atrophy and the endoscopic detection of the condition. In fact, endoscopy has the following characteristics: sensitivity, specificity, positive predictive value, negative predictive value accuracy (77.5%, 50%, 43.3%, and 65.9%) respectively for detecting stomach atrophy. Conclusion: The degree of gastritis was associated with the C-NBI's detection of an elongated pit pattern in the lower stomach. When a patient has H. pylori gastritis, the C-NBI can accurately determine stomach atrophy.

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