Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study
BackgroundThere is lack of clinical evidence supporting the value of the Kyoto classification of gastritis for the diagnosis of Helicobacter pylori (H. pylori) infection in Chinese patients, and there aren’t enough specific features for the endoscopic diagnosis of past infections, which is of specia...
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.599218/full |
| _version_ | 1818854775778705408 |
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| author | Jing Zhao Shaoxian Xu Yuan Gao Yali Lei Baicang Zou Mimi Zhou Danyan Chang Lei Dong Bin Qin |
| author_facet | Jing Zhao Shaoxian Xu Yuan Gao Yali Lei Baicang Zou Mimi Zhou Danyan Chang Lei Dong Bin Qin |
| author_sort | Jing Zhao |
| collection | DOAJ |
| description | BackgroundThere is lack of clinical evidence supporting the value of the Kyoto classification of gastritis for the diagnosis of Helicobacter pylori (H. pylori) infection in Chinese patients, and there aren’t enough specific features for the endoscopic diagnosis of past infections, which is of special significance for the prevention of early gastric cancer (GC).MethodsThis was a prospective and multicenter study with 650 Chinese patients. The H. pylori status and gastric mucosal features, including 17 characteristics based on the Kyoto classification and two newly-defined features unclear atrophy boundary (UAB) and RAC reappearance in atrophic mucosa (RAC reappearance) were recorded in a blind fashion. The clinical characteristics of the subjects were analyzed, and the diagnostic odds ratio (DOR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristics curve (ROC/AUC), and 95% confidence intervals were calculated for the different features, individually, and in combination.ResultsFor past infection, the DOR of UAB was 7.69 (95%CI:3.11−19.1), second only to map-like redness (7.78 (95%CI: 3.43−17.7)). RAC reappearance showed the highest ROC/AUC (0.583). In cases in which at least one of these three specific features of past infection was considered positive, the ROC/AUC reached 0.643. For current infection, nodularity showed the highest DOR (11.7 (95%CI: 2.65−51.2)), followed by diffuse redness (10.5 (95%CI: 4.87−22.6)). Mucosal swelling showed the highest ROC/AUC (0.726). Regular arrangement of collecting venules (RAC) was specific for no infection.ConclusionsThis study provides evidence of the clinical accuracy and robustness of the Kyoto classification of gastritis for the diagnosis of H. pylori in Chinese patients, and confirms UAB and RAC reappearance partly supplement it for the diagnosis of past infections, which is of great benefit to the early prevention of GC. |
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| language | English |
| last_indexed | 2024-12-19T07:58:04Z |
| publishDate | 2020-12-01 |
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| spelling | doaj.art-a61d40f5eb1649babb3a1f65f330aa1f2022-12-21T20:29:57ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-12-011010.3389/fonc.2020.599218599218Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter StudyJing Zhao0Shaoxian Xu1Yuan Gao2Yali Lei3Baicang Zou4Mimi Zhou5Danyan Chang6Lei Dong7Bin Qin8Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Gastroenterology, Shaanxi Provincial People’s Hospital, Xi’an, ChinaDepartment of Gastroenterology, Ankang Central Hospital, Ankang, ChinaDepartment of Gastroenterology, Weinan Central Hospital, Weinan, ChinaDepartment of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaBackgroundThere is lack of clinical evidence supporting the value of the Kyoto classification of gastritis for the diagnosis of Helicobacter pylori (H. pylori) infection in Chinese patients, and there aren’t enough specific features for the endoscopic diagnosis of past infections, which is of special significance for the prevention of early gastric cancer (GC).MethodsThis was a prospective and multicenter study with 650 Chinese patients. The H. pylori status and gastric mucosal features, including 17 characteristics based on the Kyoto classification and two newly-defined features unclear atrophy boundary (UAB) and RAC reappearance in atrophic mucosa (RAC reappearance) were recorded in a blind fashion. The clinical characteristics of the subjects were analyzed, and the diagnostic odds ratio (DOR), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristics curve (ROC/AUC), and 95% confidence intervals were calculated for the different features, individually, and in combination.ResultsFor past infection, the DOR of UAB was 7.69 (95%CI:3.11−19.1), second only to map-like redness (7.78 (95%CI: 3.43−17.7)). RAC reappearance showed the highest ROC/AUC (0.583). In cases in which at least one of these three specific features of past infection was considered positive, the ROC/AUC reached 0.643. For current infection, nodularity showed the highest DOR (11.7 (95%CI: 2.65−51.2)), followed by diffuse redness (10.5 (95%CI: 4.87−22.6)). Mucosal swelling showed the highest ROC/AUC (0.726). Regular arrangement of collecting venules (RAC) was specific for no infection.ConclusionsThis study provides evidence of the clinical accuracy and robustness of the Kyoto classification of gastritis for the diagnosis of H. pylori in Chinese patients, and confirms UAB and RAC reappearance partly supplement it for the diagnosis of past infections, which is of great benefit to the early prevention of GC.https://www.frontiersin.org/articles/10.3389/fonc.2020.599218/fullunclear atrophy boundaryRAC reappearance in atrophic mucosaearly gastric cancerHelicobacter pyloriKyoto classification of gastritis |
| spellingShingle | Jing Zhao Shaoxian Xu Yuan Gao Yali Lei Baicang Zou Mimi Zhou Danyan Chang Lei Dong Bin Qin Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study Frontiers in Oncology unclear atrophy boundary RAC reappearance in atrophic mucosa early gastric cancer Helicobacter pylori Kyoto classification of gastritis |
| title | Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study |
| title_full | Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study |
| title_fullStr | Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study |
| title_full_unstemmed | Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study |
| title_short | Accuracy of Endoscopic Diagnosis of Helicobacter pylori Based on the Kyoto Classification of Gastritis: A Multicenter Study |
| title_sort | accuracy of endoscopic diagnosis of helicobacter pylori based on the kyoto classification of gastritis a multicenter study |
| topic | unclear atrophy boundary RAC reappearance in atrophic mucosa early gastric cancer Helicobacter pylori Kyoto classification of gastritis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.599218/full |
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