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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(06): E770-E774
DOI: 10.1055/a-1136-9890
Original article

Nodularity-like appearance in the cardia: novel endoscopic findings for Helicobacter pylori infection

Osamu Toyoshima
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
2   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Toshihiro Nishizawa
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
3   Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
,
Kosuke Sakitani
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
4   Gastroenterology, Sakitani Endoscopy Clinic, Narashino, Japan
,
Tadahiro Yamakawa
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
,
Hidenobu Watanabe
5   Pathology and Cytology Laboratory Japan, Tokyo, Japan
,
Shuntaro Yoshida
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
2   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Yousuke Nakai
2   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Keisuke Hata
1   Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
6   Department of Surgical Oncology, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan
,
Hirotoshi Ebinuma
3   Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
,
Hidekazu Suzuki
7   Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
,
Kazuhiko Koike
2   Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract

Background and study aims Helicobacter pylori-associated nodular gastritis, which is associated with follicular lymphoid hyperplasia, is mainly recognized in the antrum. However, we have also observed nodularity-like appearance in the cardia. This study aimed to investigate the clinical significance of cardiac nodularity-like appearance in H. pylori-associated gastritis.

Patients and methods Patients who underwent esophagogastroduodenoscopy and were evaluated for H. pylori infection for the first time were enrolled. A nodularity-like appearance in the cardia was defined as a miliary nodular appearance or scattered appearances of small circular whitish coloration. H. pylori infection was diagnosed according to serum anti-H. pylori antibody and the urea breath test or histology. Accuracy of the H. pylori infection diagnoses based on nodularity-like appearance were assessed.

Results Among 265 patients, 42 patients (15.8 %) were diagnosed as positive for H. pylori. Cardiac nodularity-like appearance and antral nodularity were recognized in 25 and 15 patients, respectively. In accuracy of predicting H. pylori by cardiac nodularity-like appearance, specificity was 0.996, sensitivity was 0.571, positive predictive value was 0.960, negative predictive value was 0.925, and accuracy was 0.928. The sensitivity of cardiac nodularity-like appearance was significantly higher than that of antral nodularity (P = 0.0284).

Conclusions Cardiac nodularity-like appearance had a high accuracy rate for H. pylori infection diagnosis. Cardiac nodularity-like appearance was found more frequently than antral nodularity.



Publication History

Received: 08 October 2019

Accepted: 12 February 2020

Article published online:
25 May 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2020; 52(07): 626-626
DOI: 10.1055/a-1152-1906

 

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