Endoscopy International Open (Jan 2021)

Differences in image-enhanced endoscopic findings between Helicobacter pylori-associated and autoimmune gastritis

  • Minoru Kato,
  • Noriya Uedo,
  • Ervin Toth,
  • Satoki Shichijo,
  • Akira Maekawa,
  • Takashi Kanesaka,
  • Yoji Takeuchi,
  • Sachiko Yamamoto,
  • Koji Higashino,
  • Ryu Ishihara,
  • Artur Nemeth,
  • Henrik Thorlacius,
  • Yasuhiko Tomita,
  • Gabriele Wurm Johansson

DOI
https://doi.org/10.1055/a-1287-9767
Journal volume & issue
Vol. 09, no. 01
pp. E22 – E30

Abstract

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Background and study aims The aim of this study was to elucidate the differences in image-enhanced endoscopy (IEE) findings between Helicobacter-pylori-associated and autoimmune gastritis. Patients and methods Seven H. pylori-naïve, 21 patients with H. pylori-associated gastritis and seven with autoimmune gastritis were enrolled. Mucosal atrophy in the corpus was evaluated using autofluorescence imaging and classified into small, medium and large. In a 2 × 2-cm area of the lesser curvature of the lower corpus, micromucosal pattern was evaluated by magnifying narrow band imaging and proportion of foveola (FV)- and groove (GR)-type mucosa was classified into FV > 80 %, FV 50 % to 80 %, GR 50 % to 80 %, and GR > 80 %, then a biopsy specimen was taken. Results Fifteen of 21 (71 %) H. pylori-associated gastritis patients exhibited medium-to-large atrophic mucosa at the corpus lesser curvature. All autoimmune gastritis patients had large atrophic mucosa throughout the corpus (P 80 % micromucosal pattern. Nineteen of 21 (90 %) H. pylori-associated gastritis patients had varying proportions of GR- and FV-type mucosae and five of seven (71 %) autoimmune gastritis patients showed FV > 80 % mucosa (P 80 % micromucosal pattern had sensitivity of 71 % (95 % CI: 29 %–96 %) and specificity of 100 % (95 % CI: 88 % to 100 %) for diagnosis of autoimmune gastritis. Conclusions IEE findings of the gastric corpus differed between H. pylori-associated and autoimmune gastritis, suggesting different pathogenesis of the two diseases.