Correlation between endoscopic features of gastric antrum, histology and Helicobacter pylori infection in adults

Background. Helicobacter pylori induces histologic inflammation of mucosa v ariably correlated to different macroscopic features. Recent str!;lies high light that the presence of Helicobacter pylori could be assessed on the bas is of the macroscopic pattern only: in particular nodularity. The present p rospective study, has correlated this and other endoscopic features, define d by Sydney classification of gastritis, both to Helicobacter pylori presen ce and histological patterns. Results. Out of 532 patients, 364 were evaluable. The prevalence of Helicob acter pylori Mas 51.1% with a different distribution between the endoscopic features. Nodularity showed the highest positive predictive value in detec ting the Helicobacter pylori presence (69.9%). The histological findings we re: normal 26.9%, non atrophic gastritis 55.2%, atrophic gastritis 17.9%. T here was a significant difference between abnormal endoscopic features in d etecting the histologic gastritis, with endoscopic atrophy and nodularity s howing the highest positive predictive value which reaches 96.7% and 91.8%, respectively. Helicobacter pylori infection and histologic gastritis were also present in 30.9% and 41.8%, respectively: of endoscopically normal sub jects. Multivariate analysis has strictly correlated age with all abnormal endoscopic features, metaplasia with endoscopic atrophy, and chronic inflam mation (gastritis) with nodularity. Conclusions. The single endoscopic features are poorly correlated with hist ologic changes and Helicobacter pylori status. Biopsies are mandatory in al l cases. The causes of the different macroscopic findings are not yet fully understood.