Endosc Int Open 2015; 03(04): E311-E317
DOI: 10.1055/s-0034-1392090
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia

Masaaki Kodama
Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
,
Tadayoshi Okimoto
Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
,
Ryo Ogawa
Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
,
Kazuhiro Mizukami
Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
,
Kazunari Murakami
Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
› Author Affiliations
Further Information

Publication History

submitted 03 March 2015

accepted 16 March 2015

Publication Date:
26 May 2015 (eFirst)

Background and study aims: The relationship between endoscopic atrophy classification (EAC) and histological gastric atrophy and intestinal metaplasia (IM) was examined before and after Helicobacter pylori (H. pylori) eradication in order to evaluate the usefulness of EAC for detecting the risk of gastric cancer following eradication.

Patients and methods: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled. EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5, and O3(severe): 6. Histological atrophy and IM score (0 to 3) from the antrum and the corpus were evaluated with updated Sydney system for histological atrophy and IM.

Results: The mean EAC scores were 3.46 before eradication and 3.20 after eradication (P = 0.026). The mean atrophy scores before and after eradication were 1.45 and 0.92 at the antrum (P < 0.001) and 0.50 and 0.07 at the corpus (P < 0.001), respectively. The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively. The histological atrophy scores showed significant improvement after eradication, while IM showed no significant change. The Mantel-Haenszel test for trend indicated there was a significant correlation between EAC and histological atrophy and IM, except antral atrophy after eradication.

Conclusions: EAC exhibited a significant correlation between histological atrophy and IM, and represents a noninvasive classification method. EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.