Endoscopic features of Helicobacter pylori-related gastritis.
OBJECTIVE
It is still controversial whether certain endoscopic features can be used to diagnose Helicobacter pylori (Hp)-related gastritis. To clarify this issue, we performed two consecutive prospective studies.


METHODS
In the first study, we tried to identify endoscopic criteria associated with Hp-related gastritis from a total of 66 predefined gastric features on endoscopy. These features were selected by a stepwise logistic regression analysis in 101 patients. The validity of these features gained from this first study was then evaluated in a second study in 86 patients (40 with Hp gastritis, 8 with Hp-unrelated gastritis and 38 with normal gastric mucosa).


RESULTS
Three features, namely an abnormal antral surface texture, a mammillated corpus surface, and white antral erosions, were identified in the first study as independent predictors of Hp-related gastritis. However, the sensitivity and specificity of these three criteria, as assessed in the second study, were only 75% and 63% respectively.


CONCLUSIONS
We conclude that it is not possible to diagnose Hp-related gastritis on the basis of the endoscopic appearance alone. The diagnosis should be based on other criteria, such as a rapid urease test, or a histological examination of gastric biopsies, or both.
Bah
A
A
Department of Internal Medicine, CHUV/PMU, Lausanne, Switzerland.
Saraga
E
E
Armstrong
D
D
Vouillamoz
D
D
Dorta
G
G
Duroux
P
P
Weber
B
B
Froehlich
F
F
Blum
A L
AL
Schnegg
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity