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

Majima A1,2, Dohi O1, Takayama S1, Hirose R1, Inoue K1, Yoshida N1, Kamada K1, Uchiyama K1, Ishikawa T1, Takagi T1, Handa O1, Konishi H1, Naito Y1, Itoh Y1.

Gastrointest Endosc. 2019 Jul 9. pii: S0016-5107(19)32047-4. doi: 10.1016/j.gie.2019.06.043. [Epub ahead of print]

Background & aims: Limited studies have evaluated the risk factors of gastric cancer (GC) after Helicobacter pylori eradication using endoscopic findings. We aimed to investigate GC detection-related endoscopic findings after H pylori eradication 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 H pylori eradication (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=0.01 and 61.5% vs 37.7%; P=0.001, respectively) and LCI (79.8% vs 63.5%; P=0.01 and 78.0% vs 45.9%; P<0.0001, respectively). Regular arrangement of collecting venules (RAC) was significantly less frequent in CA than in NC using WLI (40.3% vs 64.7%; P=0.0009) and LCI (37.6% vs 62.4%; P=0.0006). Map-like redness was an independent positive risk finding (WLI: odds ratio, 2.05; 95% CI, 1.09-3.87; P = .03; LCI: odds ratio, 3.62; 95% CI, 1.88-6.97; P<0.001), whereas RAC was an independent negative risk finding (WLI, 0.42, 0.21-0.82; P = .01; LCI, 0.46, 0.23-0.93; P=0.03) of GC detection after H pylori eradication.

Conclusions: Map-like redness, which was identified more frequently using LCI than WLI, and the absence of RAC were associated with GC detection after H pylori eradication.

1 Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
2 Department of Gastroenterology and Hepatology, Omihachiman Community Medical Center, Omihachiman, Japan