Majima A^1,2, 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