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Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia.

Kodama M, Okimoto T, Ogawa R, Mizukami K, Murakami K - Endosc Int Open (2015)

Bottom Line: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled.The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively.EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.

View Article: PubMed Central - PubMed

Affiliation: Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.

ABSTRACT

Background and study aims: The relationship between endoscopic atrophy classification (EAC) and histological gastric atrophy and intestinal metaplasia (IM) was examined before and after Helicobacter pylori (H. pylori) eradication in order to evaluate the usefulness of EAC for detecting the risk of gastric cancer following eradication.

Patients and methods: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled. EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5, and O3(severe): 6. Histological atrophy and IM score (0 to 3) from the antrum and the corpus were evaluated with updated Sydney system for histological atrophy and IM.

Results: The mean EAC scores were 3.46 before eradication and 3.20 after eradication (P = 0.026). The mean atrophy scores before and after eradication were 1.45 and 0.92 at the antrum (P < 0.001) and 0.50 and 0.07 at the corpus (P < 0.001), respectively. The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively. The histological atrophy scores showed significant improvement after eradication, while IM showed no significant change. The Mantel-Haenszel test for trend indicated there was a significant correlation between EAC and histological atrophy and IM, except antral atrophy after eradication.

Conclusions: EAC exhibited a significant correlation between histological atrophy and IM, and represents a noninvasive classification method. EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.

No MeSH data available.


Related in: MedlinePlus

 Relationship between endoscopic and histological findings. Another case of endoscopic findings before eradication (a, b) and 7 years after eradication (c, d) (white arrows: atrophic border) showed no improvement. Histological findings at the corpus (e) and antrum (f) before eradication improved at the corpus (g) and antrum (h) after eradication.
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FI174-4:  Relationship between endoscopic and histological findings. Another case of endoscopic findings before eradication (a, b) and 7 years after eradication (c, d) (white arrows: atrophic border) showed no improvement. Histological findings at the corpus (e) and antrum (f) before eradication improved at the corpus (g) and antrum (h) after eradication.

Mentions: Fig. 3 presents the endoscopic and histological atrophy and IM before and after eradication. Seven years after successful eradication, EAC improved from O2 (Fig. 3 a, b) to C3 (Fig. 3 c, d). Histological atrophy also improved 2 to 0 after eradication at both the antrum (Fig. 3 f, h) and the corpus (Fig. 3 e, g ). Similarly, the IM score at the antrum improved from 2 to 0 (Fig. 3 f, h). Fig. 4 presents another case. Seven years after successful eradication, this case did not show improvement in EAC, with scores of O2 ( Fig. 4 a, b) to O2 (Fig. 4 c, d). However, histological atrophy improved from 2 to 0 after eradication at both the antrum (Fig. 4 f, h) and corpus (Fig. 4 e, g). The IM score at the antrum also improved from 1 to 0 (Fig. 4 f, h).


Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia.

Kodama M, Okimoto T, Ogawa R, Mizukami K, Murakami K - Endosc Int Open (2015)

 Relationship between endoscopic and histological findings. Another case of endoscopic findings before eradication (a, b) and 7 years after eradication (c, d) (white arrows: atrophic border) showed no improvement. Histological findings at the corpus (e) and antrum (f) before eradication improved at the corpus (g) and antrum (h) after eradication.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4554494&req=5

FI174-4:  Relationship between endoscopic and histological findings. Another case of endoscopic findings before eradication (a, b) and 7 years after eradication (c, d) (white arrows: atrophic border) showed no improvement. Histological findings at the corpus (e) and antrum (f) before eradication improved at the corpus (g) and antrum (h) after eradication.
Mentions: Fig. 3 presents the endoscopic and histological atrophy and IM before and after eradication. Seven years after successful eradication, EAC improved from O2 (Fig. 3 a, b) to C3 (Fig. 3 c, d). Histological atrophy also improved 2 to 0 after eradication at both the antrum (Fig. 3 f, h) and the corpus (Fig. 3 e, g ). Similarly, the IM score at the antrum improved from 2 to 0 (Fig. 3 f, h). Fig. 4 presents another case. Seven years after successful eradication, this case did not show improvement in EAC, with scores of O2 ( Fig. 4 a, b) to O2 (Fig. 4 c, d). However, histological atrophy improved from 2 to 0 after eradication at both the antrum (Fig. 4 f, h) and corpus (Fig. 4 e, g). The IM score at the antrum also improved from 1 to 0 (Fig. 4 f, h).

Bottom Line: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled.The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively.EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.

View Article: PubMed Central - PubMed

Affiliation: Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.

ABSTRACT

Background and study aims: The relationship between endoscopic atrophy classification (EAC) and histological gastric atrophy and intestinal metaplasia (IM) was examined before and after Helicobacter pylori (H. pylori) eradication in order to evaluate the usefulness of EAC for detecting the risk of gastric cancer following eradication.

Patients and methods: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled. EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5, and O3(severe): 6. Histological atrophy and IM score (0 to 3) from the antrum and the corpus were evaluated with updated Sydney system for histological atrophy and IM.

Results: The mean EAC scores were 3.46 before eradication and 3.20 after eradication (P = 0.026). The mean atrophy scores before and after eradication were 1.45 and 0.92 at the antrum (P < 0.001) and 0.50 and 0.07 at the corpus (P < 0.001), respectively. The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively. The histological atrophy scores showed significant improvement after eradication, while IM showed no significant change. The Mantel-Haenszel test for trend indicated there was a significant correlation between EAC and histological atrophy and IM, except antral atrophy after eradication.

Conclusions: EAC exhibited a significant correlation between histological atrophy and IM, and represents a noninvasive classification method. EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.

No MeSH data available.


Related in: MedlinePlus