ENDOSCOPIC FEATURES OF HELICOBACTER PYLORI-RELATED GASTRITIS

Background and Study Aims: It is still controversial whether certain e ndoscopic features can be used to diagnose Helicobacter pylori (Hp)-re lated gastritis. To clarify this issue, we performed two consecutive p rospective studies. Patients and Methods: In the first study, we tried to identify endoscopic criteria associated with Hp-related gastritis from a total of 66 predefined gastric features on endoscopy. These fea tures were selected by a stepwise logistic regression analysis in 101 patients. The validity of these features gained from this first study was then evaluated in a second study in 86 patients (40 with Hp gastri tis, 8 with Hp-unrelated gastritis and 38 with normal gastric mucosa). Results: Three features, namely an abnormal antral surface texture, a mammillated corpus surface, and white antral erosions, were identifie d in the first study as independent predictors of Hp-related gastritis . However, the sensitivity and specificity of these three criteria, as assessed in the second study, were only 75% and 63% respectively. Con clusions: We conclude that it is not possible to diagnose Hp-related g astritis on the basis of the endoscopic appearance alone. The diagnosi s should be based on other criteria, such as a rapid urease test, or a histological examination of gastric biopsies, or both.