Diagnostic value of gastric mucosal morphology changes detected by white light gastroscopy in Helicobacter pylori infection

doi:10.3877/cma.j.issn.1674-0785.2022.02.008

Abstract

Abstract:

Objective

To explore the diagnostic value of gastric mucosal morphology changes detected by white light gastroscopy in Helicobacter pylori (H. pylori) infection-related gastritis.

Methods

A retrospective analysis was performed on 1160 patients who underwent white light gastroscopy and 13-urea breath test (¹³C-UBT) at the Second Affiliated Hospital of Hainan Medical University from July 2018 to July 2020, and the patients were divided either an H. pylori infection group (812 cases) or a non-H. pylori infection group (348 cases) based on the results of ¹³C-UBT. The differences in gastric mucosal morphology detected by white light gastroscopy were compared between the two groups, and Logistic regression analysis was performed to screen out the gastric mucosa morphological characteristics independently related to H. pylori infection. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of the related indicators.

Results

The detection rates for diffuse gastric mucosal congestion, punctate redness, gastric mucosal swelling, snake-shaped enlarged gastric folds, and moire gastric mucosa by white light gastroscopy in the H. pylori infection group were significantly higher than those in the non-H. pylori infection group. Multivariate Logistic regression analysis showed that diffuse gastric mucosal congestion (odds ratio [OR]=116.280), punctate redness (OR=4.821), gastric mucosal swelling (OR=3.432), snake-shaped enlarged gastric folds (OR=4.336), and moire gastric mucosa (OR=9.346) were independent factors for H. pylori infection. ROC curve analysis showed that the areas under the curves of diffuse gastric mucosal congestion, punctate redness, gastric mucosal swelling, snake-shaped enlarged gastric folds, and moire gastric mucosa in predicting H. pylori infection were 0.829 (95%CI: 0.796~0.859), 0.687 (95%CI: 0.648~0.725), 0.750 (95%CI: 0.713~0.785), 0.578 (95%CI: 0.537~0.619), and 0.619 (95%CI: 0.578~0.619), respectively. Among them, the areas of curves of diffuse gastric mucosal congestion and gastric mucosal swelling were larger, and the sensitivity and specificity were 93.68% and 72.17%, and 97.13% and 52.96%, respectively.

Conclusion

Gastric mucosal morphology changes detected by white light gastroscopy are related to H. pylori infection. Diffuse gastric mucosal congestion and gastric mucosal swelling are more valuable in the diagnosis of H. pylori infection.

Key words: White light gastroscopy, Gastric mucosa, Helicobacter pylori, Gastritis, Diagnostic value

Wei Li, Xiaoli Chen, Rensong Cai, Li Zhu, Suting Yan, Xiaoli Xing. Diagnostic value of gastric mucosal morphology changes detected by white light gastroscopy in Helicobacter pylori infection[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(02): 152-156.

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References 19

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白光胃镜下黏膜形态	H. pylori感染组（812例）	无H. pylori感染组（348例）	χ²值	P值
弥漫性胃黏膜充血	586（72.17）	23（6.61）	422.919	＜0.001
点状发红	348（42.86）	36（10.34）	116.278	＜0.001
斑片状发红	122（15.02）	52（14.94）	0.001	0.971
地图状发红	6（0.74）	7（2.01）	3.56	0.059
胃黏膜肿胀	430（52.96）	11（3.16）	256.326	＜0.001
胃体皱襞肿大蛇形	131（16.13）	2（0.57）	58.089	＜0.001
胃体黏膜黏液多且浑浊	73（8.99）	36（10.34）	0.525	0.469
胃体黏膜呈“龟纹样”	258（31.77）	29（8.33）	71.881	＜0.001
黄色素瘤	15（1.85）	12（3.45）	2.746	0.097
多发白色扁平隆起	2（0.25）	3（0.86）	-	0.163
陈旧性出血斑	37（4.56）	16（4.60）	0.001	0.976
隆起性糜烂	45（5.54）	25（7.18）	1.158	0.282
凹陷性糜烂	85（10.47）	36（10.34）	0.004	0.950

白光胃镜下黏膜形态	H. pylori感染组（812例）	无H. pylori感染组（348例）	χ²值	P值
弥漫性胃黏膜充血	586（72.17）	23（6.61）	422.919	＜0.001
点状发红	348（42.86）	36（10.34）	116.278	＜0.001
斑片状发红	122（15.02）	52（14.94）	0.001	0.971
地图状发红	6（0.74）	7（2.01）	3.56	0.059
胃黏膜肿胀	430（52.96）	11（3.16）	256.326	＜0.001
胃体皱襞肿大蛇形	131（16.13）	2（0.57）	58.089	＜0.001
胃体黏膜黏液多且浑浊	73（8.99）	36（10.34）	0.525	0.469
胃体黏膜呈“龟纹样”	258（31.77）	29（8.33）	71.881	＜0.001
黄色素瘤	15（1.85）	12（3.45）	2.746	0.097
多发白色扁平隆起	2（0.25）	3（0.86）	-	0.163
陈旧性出血斑	37（4.56）	16（4.60）	0.001	0.976
隆起性糜烂	45（5.54）	25（7.18）	1.158	0.282
凹陷性糜烂	85（10.47）	36（10.34）	0.004	0.950

白光胃镜下黏膜形态	β值	SE	Wald值	P值	OR值	95%CI
弥漫性胃黏膜充血	4.756	0.426	124.642	＜0.001	116.280	50.453~267.993
点状发红	1.573	0.354	19.745	＜0.001	4.821	2.409~9.649
胃黏膜肿胀	1.233	0.336	13.466	＜0.001	3.432	1.776~6.630
胃体皱襞肿大蛇形	1.467	0.348	17.771	＜0.001	4.336	2.192~8.577
胃体黏膜呈“龟纹样”	2.235	0.378	35.522	＜0.001	9.346	4.482~19.492

白光胃镜下黏膜形态	β值	SE	Wald值	P值	OR值	95%CI
弥漫性胃黏膜充血	4.756	0.426	124.642	＜0.001	116.280	50.453~267.993
点状发红	1.573	0.354	19.745	＜0.001	4.821	2.409~9.649
胃黏膜肿胀	1.233	0.336	13.466	＜0.001	3.432	1.776~6.630
胃体皱襞肿大蛇形	1.467	0.348	17.771	＜0.001	4.336	2.192~8.577
胃体黏膜呈“龟纹样”	2.235	0.378	35.522	＜0.001	9.346	4.482~19.492

白光胃镜下黏膜形态	AUC值	SE	P值	95%CI	特异度（%）	敏感度（%）
弥漫性胃黏膜充血	0.829	0.015	＜0.001	0.796~0.859	93.68	72.17
点状发红	0.687	0.017	＜0.001	0.648~0.725	89.66	47.78
胃黏膜肿胀	0.750	0.014	＜0.001	0.713~0.785	97.13	52.96
胃体皱襞肿大蛇形	0.578	0.009	＜0.001	0.537~0.619	99.43	16.26
胃体黏膜呈“龟纹样”	0.619	0.015	＜0.001	0.578~0.619	91.95	31.77

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