EVALUATION OF PREMALIGNANT GASTRIC CONDITIONS IN HELICOBACTER PYLORI RELATED CHRONIC GASTRITIS: DEFINITION OF TIMING

Aims Helicobacter pylori (HP) infection is commonly responsible for premalignant gastric conditions (PGC) -atrophic gastritis, intestinal metaplasia and dysplasia – and malignant gastric lesions (MGL). High-Resolution White Light Endoscopy (HR-WLE) in combination with Blue Laser Imaging (BLI) – Linked color imaging (LCI) is effective in detecting PGC.

Methods Thirty-three consecutive cases of HP related chronic gastritis were retrospectively examined for PGC and MGL by HR-WLE and BLI-LCI before eradication therapy (n=33) and two months (n=28) and six months (n=23) after eradication therapy. The Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) classification, on the endoscopic side, and the Operative-Link on Gastritis-Assessment (OLGA) and the Operative-Link on Gastric-Intestinal Metaplasia (OLGIM) classifications, on the histological side, were taken into account. Gastroscopy was performed by endoscopists not particularly experienced in virtual chromoendoscopy.

Results After HP eradication, the assessed endoscopic and/or histological stage changed in 81% of the cases at two months and in 91% at six months. MALT hyperplasia improved in 90% at six months. Confounding elements (redness, erosion and surface variations) were significantly reduced at two months (p<0.001) and gastric lesions were distinctly visible at six months (p=0.05).

Conclusions HP eradication is important for the correct endoscopic (EGGIM stage) and histological (OLGA/OLGIM stage) evaluation of HP-related chronic gastritis when gastroscopy with HR – WLE and BLI-LCI is performed by endoscopists not particularly experienced in virtual chromoendoscopy.

Publication History

Article published online:
14 April 2022