Endoscopic patterns of gastric mucosa and its clinicopathological significance

摘要

AIM: To explore the correlation of magnifying endoscopic patterns and histopathology, Helicobacter pylori (H pylori) infection of the gastric mucosa. METHODS: Gastric mucosal patterns in 140 patients with chronic gastritis were studied using Olympus GIF-Q240Z magnifying endoscope. Histopathological examination, rapid urease test and Warrthin-Starry staining were taken with biopsy samples from the magnified sites of stomach. The magnifying endoscopic patterns were compared with histopathological results and H pylori detection. RESULTS: The pit patterns of gastric mucosa were classified as types A (round spot), B (short rod), C (branched), D (reticular) and E (villus). The detection rate of chronic atrophic gastritis (CAG) by magnifying endoscopy was 94.3% (33/35), which was significantly higher than that by routine endoscopy (22.9%, 8/35) (P<0.01). The pit patterns of 31 cases of intestinal metaplasia (IM) appeared as type E in 18 cases (58.1%), type D in 8 cases (25.8%) and type C in 5 cases (16.1%). Fourteen out of 18 patients (77.8%) with complete type (type Ⅰ) of IM appeared as type E of pit patterns, whereas only 4 of 13 (30.8%) patients with incomplete type (types Ⅱ and Ⅲ) of IM appeared as type E (P<0.05). Collecting venules in the anterior of lower part of gastric corpus were subgrouped into types R (regular), I (irregular) and D (disappeared). H pylori infection was found in 12.2% (9/74), 60%(9/15) and 84.3%(43/51) cases in these types respectively. H pylori infection rate in type R was significantly lower than that in other two types CONCLUSION: Magnifying endoscopy may have an obvious value in diagnosing chronic atrophic gastritis, intestinal metaplasia and H pylori infection.