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Changes in gastric mucosal patterns seen by magnifying NBI during H. pylori eradication

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Abstract

Background

Magnifying narrow-band imaging (NBI) endoscopy visualizes superficial gastric mucosal and capillary patterns. We aimed to investigate changes in gastric mucosal patterns seen by magnifying NBI endoscopy after Helicobacter pylori eradication.

Methods

Gastric mucosal patterns in non-pathological gastric corpus were observed by magnifying NBI endoscopy before and 12 weeks after H. pylori eradication in thirty patients. By using paired photographs of each case, changes in NBI mucosal patterns during H. pylori eradication were judged in a consensus manner by three blinded endoscopists.

Results

At 12 weeks after H. pylori eradication, 20 of 24 subjects who had been successfully treated showed remarkable changes in gastric mucosal patterns (sensitivity 83.3%, specificity 100%). In the specimens from these subjects, the patterns of enlarged or elongated pits were improved to small oval or pinhole-like round pits, and the density of fine irregular vessels was decreased. Histological assessment showed alleviation of chronic inflammation in all subjects (p < 0.0001), while such a change was not observed for four subjects showing severe gastric atrophy and intestinal metaplasia. When the subjects were divided according to the presence of severe gastric atrophy, the diagnostic efficacy of magnifying NBI for predicting the results of H. pylori eradication was excellent in subjects without severe gastric atrophy and intestinal metaplasia (sensitivity and specificity, 100%). However, no change in the NBI mucosal pattern was observed in subjects with severe gastric atrophy and intestinal metaplasia, regardless of the H. pylori eradication result.

Conclusions

At least in subjects without severe gastric atrophy or intestinal metaplasia, successful H. pylori eradication treatment shows improvements in gastric mucosal patterns with the use of magnifying NBI endoscopy early after successful treatment.

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Abbreviations

H. pylori :

Helicobacter pylori

NBI:

Narrow band imaging

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Acknowledgments

We thank Dr Tsuneo Oyama, and other staff of the Department of Gastroenterology, Saku Central Hospital, for their advice to T. Tahara during his training in ESD and magnifying NBI endoscopy at Saku Central Hospital, January 2007 to April 2007. This study was partly supported by Grant-in-Aid “The Japanese Foundation for Research and Promotion of Endoscopy (JFE)” and “Katano award”, which is a 50th anniversary memory of the Kansai Medical University class reunion.

Conflict of interest

No conflicts of interest exist.

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Authors and Affiliations

  1. Department of Gastroenterology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

    Masaaki Okubo, Tomomitsu Tahara, Tomoyuki Shibata, Masakatsu Nakamura, Daisuke Yoshioka, Yoshiteru Maeda, Joh Yonemura, Takamitsu Ishizuka & Ichiro Hirata

  2. Department of Gastroenterology, Kanazawa Medical University, 1-1 Daigaku, Uchinadamachi, Ishikawa, 920-0293, Japan

    Tomiyasu Arisawa

Authors
  1. Masaaki Okubo
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  2. Tomomitsu Tahara
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  3. Tomoyuki Shibata
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  4. Masakatsu Nakamura
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  5. Daisuke Yoshioka
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  6. Yoshiteru Maeda
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  7. Joh Yonemura
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  8. Takamitsu Ishizuka
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  9. Tomiyasu Arisawa
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  10. Ichiro Hirata
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Corresponding author

Correspondence to Tomomitsu Tahara.

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Okubo, M., Tahara, T., Shibata, T. et al. Changes in gastric mucosal patterns seen by magnifying NBI during H. pylori eradication. J Gastroenterol 46, 175–182 (2011). https://doi.org/10.1007/s00535-010-0335-0

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  • DOI: https://doi.org/10.1007/s00535-010-0335-0

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