Mucosal patterns of Helicobacter pylori-related gastritis without atrophy in the gastric corpus using standard endoscopy

AIM:To identify the mucosal patterns of Helicobacter pylori(H.pylori )-related gastritis in the gastric corpus using standard endoscopy and to evaluate their reproducibility.METHODS:A total of 112 consecutive patients underwent upper gastrointestinal endoscopy.The endoscopists classified the endoscopic findings into 4 patterns.In the second part of the study,90 images were shown to 3 endoscopists in order to evaluate the inter-observer and intra-observer variability in image assessment.RESULTS:The mucosal patterns of the gastric bodywere categorized into 4 types.Type 1 pattern was defined as cleft-like appearance,type 2 as regular arrangement of red dots,type 3 pattern as the mosaic mucosal pattern and type 4 pattern as the mosaic pattern with a focal area of hyperemia.Type 1 and type 2 mucosal patterns were statistically significant in predicting H.pylorinegative status as compared with other mucosal types(χ 2 = 12.79 and 61.25 respectively,P < 0.01).Type 3 and type 4 mucosal patterns were statistically significant in predicting a H.pylori-positive status as compared with other mucosal types(χ 2 = 21.22 and 11.02 respectively,P < 0.01).Furthermore,the sensitivity,specificity,positive and negative predictive values of type 3 plus type 4 patterns for predicting H.pylori-positive gastric mucosa were 100%,86%,94%,and 100%,respectively.The mean κ values for inter-and intra-observer agreement in assessing the various endoscopic patterns were 0.808(95% CI,0.678-0.938) and 0.826(95% CI,0.727-0.925) respectively.CONCLUSION:Our study suggests that mucosal patterns in H.pylori-infected gastric mucosa without atrophy can be reliably identified using standard endoscopy in the gastric corpus.