Improved Detection of Helicobacter pylori Infection and Premalignant Gastric Mucosa Using Conventional White Light Source Gastroscopy

  • Matrakool, Likit (School of Surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Tongtawee, Taweesak (School of Surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Bartpho, Theeraya (School of Surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Dechsukhum, Chavaboon (School of Pathology, Institute of Medicine, Suranaree University of Technology) ;
  • Loyd, Ryan A (School of Family Medicine and Community Medicine, Institute of Medicine, Suranaree University of Technology) ;
  • Kaewpitoon, Soraya J (School of Family Medicine and Community Medicine, Institute of Medicine, Suranaree University of Technology) ;
  • Kaewpitoon, Natthawut (Faculty of Public health, Vongchavalitkul University)
  • Published : 2016.06.01


Background: The gold standard diagnosis of H. pylori related gastritis is evidence of bacteria on histopathological examination of gastric mucosa. Our aim was to study the correlation between gastric mucosal morphology and histopathological severity of H. pylori related gastritis. Materials and Methods: Division was made on morphological features into:Type 1, showing regular arrangement of red dots; Type 2, showing cleft-like appearance; Type 3, with a mosaic appearance; and Type 4, having a mosaic appearance with focal or diffuse hyperemia. Results: Types 1 and 2 gastric mucosal morphologies were statistically significant in predicting an H. pylori negative status (137/145, p<0.01), while Types 3 and 4 were significant a positive status (139/155, p<0.01). The sensitivity, specificity, positive and negative predictive values of Type 3 and 4 morphologies for predicting H. pylori positive were 94.6%, 89.5%, 89.7% and 94.5%, respectively, with a good correlation with inflammation grading (p<0.01). Conclusions: Our study suggests that gastric mucosal morphology can be reliably identified using conventional white light source gastroscopy with good correlation between findings and inflammation grading.


Supported by : Suranaree University of Technology


  1. Anagnostopoulos GK, Yao K, Kaye P, et al (2007). Highresolution magnification endoscopy can reliably identify normal gastric mucosa, Helicobacter pylori associated gastritis, and gastric atrophy. Endoscopy, 39, 202-7.
  2. Bah A, Saraga E, Armstrong D, et al (1995). Endoscopic features of Helicobacter pylori-related gastritis. Endoscopy, 27, 593-6.
  3. Dixon MF, Genta RM, Yardley JH, et al (1996). Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston. Am J Surg Pathol, 20, 1161-81.
  4. Laine L, Cohen H, Sloane R, et al (1995). Interobserver agreement and predictive value of endoscopic findings for H. pylori and gastritis in normal volunteers. Gastrointest. Endosc, 42, 420-3.
  5. Malfertheiner P, Megraud F, O’Morain C, et al (2002). Current concepts in the management of Helicobacter pylori infection-the Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther, 16, 167-80.
  6. Mihara M, Haruma K, Kamada T, et al (1999). The role of endoscopic findings for the diagnosis of Helicobacter pylori infection: evaluation in a country with high prevalence of atrophic gastritis. Helicobacter, 4, 40-8.
  7. Redeen S, Petersson F, Jonsson KA, et al (2003). Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample. Endoscopy, 35, 946-50.
  8. Sugano K, Tack J, Kuipers EJ, et al (2015). Kyoto global consensus report on Helicobacter pylori gastritis. Gut, 64, 1353-67.
  9. Taweesak T, Soraya K, Natthawut K, et al (2015). Correlation between gastric mucosal morphologic patterns and histopathological severity of Helicobacter pylori associated gastritis using conventional narrow band imaging gastroscopy. Biomed Res Int, 7, 42-8.
  10. Taweesak T, Chavaboon D, Wilairat L, et al (2015). Improved detection of Helicobacter pylori infection and premalignant gastric mucosa using "site specific biopsy": a randomized control clinical Trial. Asian Pac J Cancer Prev, 16, 8487- 90.
  11. Tytgat GN (1991). The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodinitis. J Gastroenterol Hepatol, 6, 223-34.
  12. Yagi K, Nakamura A, Sekine A, et al (2002). Characteristic endoscopic and magnifiedendoscopic findings in the normal stomach without Helicobacter pylori infection. J. Gastroenterol. Hepatol, 17, 39-45.
  13. Yagi K, Nakamura A, Sekine A, et al (2002). Comparison between magnifying endoscopy and histological, culture and urease test findings from the gastric mucosa of the corpus. Endoscopy, 34, 376-81.
  14. Yagi K, Honda H, Yang JM, et al (2005). Magnifying endoscopy in gastritis of the corpus. Endoscopy, 37, 660-6.
  15. Yan SL, Wu ST, Chen CH et al (2010). Mucosal patterns of Helicobacter pylori-related gastritis without atrophy in the gastric corpus using standard endoscopy. World J Gastroenterol, 16, 496-500.

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