Endoscopic patterns of gastric mucosa and its clinicopathological significance.

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 (P<0.01).

CONCLUSION

Magnifying endoscopy may have an obvious value in diagnosing chronic atrophic gastritis, intestinal metaplasia and H pylori infection.