Linked color imaging identifies important risk factors associated with gastric cancer after successful eradication of Helicobacter pylori

Gastrointest Endosc. 2019 Nov;90(5):763-769. doi: 10.1016/j.gie.2019.06.043. Epub 2019 Jul 9.

Abstract

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.

MeSH terms

  • Aged
  • Atrophy / diagnostic imaging
  • Case-Control Studies
  • Color
  • Cross-Sectional Studies
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Gastric Mucosa / blood supply
  • Gastric Mucosa / diagnostic imaging*
  • Gastric Mucosa / pathology*
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Stomach Neoplasms / diagnostic imaging*
  • Venules / diagnostic imaging