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

DOI PDF 6 Citations Open Access
  • Osamu Toyoshima
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Toshihiro Nishizawa
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Kosuke Sakitani
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Tadahiro Yamakawa
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Hidenobu Watanabe
    Pathology and Cytology Laboratory Japan, Tokyo, Japan
  • Shuntaro Yoshida
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Yousuke Nakai
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  • Keisuke Hata
    Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan
  • Hirotoshi Ebinuma
    Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
  • Hidekazu Suzuki
    Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
  • Kazuhiko Koike
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

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<jats:title>Abstract</jats:title><jats:p> 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.</jats:p><jats:p> 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.</jats:p><jats:p> 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).</jats:p><jats:p> 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.</jats:p>

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