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Endoscopic atrophic classification before and after H pylori eradication is
closely associated with histological atrophy and intestinal metaplasia
#MMPMID26357676
Kodama M
; Okimoto T
; Ogawa R
; Mizukami K
; Murakami K
Endosc Int Open
2015[Aug]; 3
(4
): E311-7
PMID26357676
show ga
BACKGROUND AND STUDY AIMS: The relationship between endoscopic atrophy
classification (EAC) and histological gastric atrophy and intestinal metaplasia
(IM) was examined before and after Helicobacter pylori (H. pylori) eradication in
order to evaluate the usefulness of EAC for detecting the risk of gastric cancer
following eradication. PATIENTS AND METHODS: A total of 230 patients (137 males,
93 females; mean age: 58.0?±?11.8?y) with successful eradication were enrolled.
EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5,
and O3(severe): 6.?Histological atrophy and IM score (0 to 3) from the antrum and
the corpus were evaluated with updated Sydney system for histological atrophy and
IM. RESULTS: The mean EAC scores were 3.46 before eradication and 3.20 after
eradication (P?=?0.026). The mean atrophy scores before and after eradication
were 1.45 and 0.92?at the antrum (P?0.001) and 0.50 and 0.07?at the corpus
(P?0.001), respectively. The mean IM scores before and after eradication were
0.55 and 0.47?at the antrum (P?=?0.154), and 0.09 and 0.05?at the corpus
(P?=?0.096), respectively. The histological atrophy scores showed significant
improvement after eradication, while IM showed no significant change. The
Mantel-Haenszel test for trend indicated there was a significant correlation
between EAC and histological atrophy and IM, except antral atrophy after
eradication. CONCLUSIONS: EAC exhibited a significant correlation between
histological atrophy and IM, and represents a noninvasive classification method.
EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori
eradication.