A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status

Abstract Objectives During esophagogastroduodenoscopy, a red linear scrape‐like appearance with white deposits sometimes appears on the gastric mucosa at the lower greater curvature of the gastric body, a finding we named the “scratch sign.” We aimed to clarify the clinical significance of this new...

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Main Authors: Tomoyuki Yada, Yoshiyuki Itakura, Ryo Watanabe, Keita Odaka, Toyokazu Yagi, Yurika Ikegami, Katsunori Sekine, Naomi Uemura
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.200
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author Tomoyuki Yada
Yoshiyuki Itakura
Ryo Watanabe
Keita Odaka
Toyokazu Yagi
Yurika Ikegami
Katsunori Sekine
Naomi Uemura
author_facet Tomoyuki Yada
Yoshiyuki Itakura
Ryo Watanabe
Keita Odaka
Toyokazu Yagi
Yurika Ikegami
Katsunori Sekine
Naomi Uemura
author_sort Tomoyuki Yada
collection DOAJ
description Abstract Objectives During esophagogastroduodenoscopy, a red linear scrape‐like appearance with white deposits sometimes appears on the gastric mucosa at the lower greater curvature of the gastric body, a finding we named the “scratch sign.” We aimed to clarify the clinical significance of this new endoscopic finding in the endoscopic evaluation of the Helicobacter pylori infection status. Methods Among patients who underwent esophagogastroduodenoscopy at our hospital between October 2016 and June 2017, 437 patients were included in the study. We first examined the overall scratch sign positivity rate, and then this was compared according to the H. pylori infection status. Subsequently, other variables were compared and examined between the positive and negative scratch sign groups. Results Overall, 437 patients were included in the analysis. The scratch sign was observed in 1.4% of 71 patients with current infections, 26.9% of 290 patients with past infections, and 31.6% of 76 uninfected patients. In the multivariate analysis, H. pylori‐negative, severe gastric mucosal atrophy, and acid secretion depressant were independent factors that significantly affected the appearance of the scratch sign. Conclusions A novel endoscopic finding, the scratch sign, was found to be a good endoscopic predictor of H. pylori‐negative gastric mucosa. Furthermore, combined with atrophic changes and xanthomas that persisted after eradication, these findings were found to be useful in accurately diagnosing H. pylori past‐infected gastric mucosa endoscopically.
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spelling doaj.art-beb9d7b57c344a2aa3d6db3f68c602642023-04-29T05:12:58ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.200A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection statusTomoyuki Yada0Yoshiyuki Itakura1Ryo Watanabe2Keita Odaka3Toyokazu Yagi4Yurika Ikegami5Katsunori Sekine6Naomi Uemura7Division of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanDivision of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine Chiba JapanAbstract Objectives During esophagogastroduodenoscopy, a red linear scrape‐like appearance with white deposits sometimes appears on the gastric mucosa at the lower greater curvature of the gastric body, a finding we named the “scratch sign.” We aimed to clarify the clinical significance of this new endoscopic finding in the endoscopic evaluation of the Helicobacter pylori infection status. Methods Among patients who underwent esophagogastroduodenoscopy at our hospital between October 2016 and June 2017, 437 patients were included in the study. We first examined the overall scratch sign positivity rate, and then this was compared according to the H. pylori infection status. Subsequently, other variables were compared and examined between the positive and negative scratch sign groups. Results Overall, 437 patients were included in the analysis. The scratch sign was observed in 1.4% of 71 patients with current infections, 26.9% of 290 patients with past infections, and 31.6% of 76 uninfected patients. In the multivariate analysis, H. pylori‐negative, severe gastric mucosal atrophy, and acid secretion depressant were independent factors that significantly affected the appearance of the scratch sign. Conclusions A novel endoscopic finding, the scratch sign, was found to be a good endoscopic predictor of H. pylori‐negative gastric mucosa. Furthermore, combined with atrophic changes and xanthomas that persisted after eradication, these findings were found to be useful in accurately diagnosing H. pylori past‐infected gastric mucosa endoscopically.https://doi.org/10.1002/deo2.200endoscopic findingesophagogastroduodenoscopygastritisHelicobacter pyloriscratch sign
spellingShingle Tomoyuki Yada
Yoshiyuki Itakura
Ryo Watanabe
Keita Odaka
Toyokazu Yagi
Yurika Ikegami
Katsunori Sekine
Naomi Uemura
A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
DEN Open
endoscopic finding
esophagogastroduodenoscopy
gastritis
Helicobacter pylori
scratch sign
title A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
title_full A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
title_fullStr A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
title_full_unstemmed A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
title_short A novel endoscopic finding of a scratch sign is useful for evaluating the Helicobacter pylori infection status
title_sort novel endoscopic finding of a scratch sign is useful for evaluating the helicobacter pylori infection status
topic endoscopic finding
esophagogastroduodenoscopy
gastritis
Helicobacter pylori
scratch sign
url https://doi.org/10.1002/deo2.200
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