See the published version of this preprint at BMC Gastroenterology.
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Research article
Tadakazu Hisamatsu
Kyorin University School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2271-5141
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Gastric cancer after Helicobacter pylori (HP) eradication is a crucial clinical challenge today as HP eradication therapy is widely performed. Detecting gastric cancer after HP eradication tends to be difficult with normal white-light endoscopy. In the present study, we aimed to identify easily-evaluated endoscopic findings that indicate the presence of gastric cancer after HP eradication so that endoscopists can consider additional detailed examinations at the site.
Methods
We analyzed the endoscopic images of 43 patients who underwent endoscopic submucosal dissection for early gastric cancer after HP eradication and 119 patients with an HP eradication history who underwent esophagogastroduodenoscopy for a medical checkup. Endoscopic findings were evaluated according to the Kyoto classification of gastritis (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) and map-like redness.
Results
Patients with gastric cancer had significantly higher total Kyoto risk scores; more atrophy, intestinal metaplasia, and diffuse redness; and a significantly higher prevalence of map-like redness compared with those without gastric cancer, in the univariate analyses. We used logistic regression analysis with forward selection based on the likelihood ratio to develop a model using atrophy and diffuse redness. Receiver operating characteristic analysis showed that a score of A2 in the Kyoto classification of gastritis (open-type atrophic pattern in the Kimura–Takemoto classification) was an endoscopic marker for the presence of post-HP-eradication gastric cancer.
Conclusions
Endoscopic severe gastric mucosal atrophy is useful to screen patients for gastric cancer after HP eradication.
Keywords
Stomach Neoplasms, Helicobacter pylori, Atrophy, Endoscopy
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View the published article at BMC Gastroenterology.
Version 1
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Review #1 received
Received 24 May, 2020
Review #4 received
Received 24 May, 2020
Editorial decision: Major revision
On 24 May, 2020
Review #3 received
Received 20 May, 2020
Review #2 received
Received 14 May, 2020
Reviewer #4 agreed
On 03 May, 2020
Reviewer #3 agreed
On 28 Apr, 2020
Reviewer #2 agreed
On 24 Apr, 2020
Editor assigned
On 21 Apr, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Submission checks complete
On 17 Apr, 2020
Editor invited
On 17 Apr, 2020
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Subject Areas
Gastroenterology & Hepatology
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See the published version of this preprint at BMC Gastroenterology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tadakazu Hisamatsu
Kyorin University School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2271-5141
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 1
Posted 22 Apr, 2020
No community comments so far
Review #1 received
Received 24 May, 2020
Review #4 received
Received 24 May, 2020
Editorial decision: Major revision
On 24 May, 2020
Review #3 received
Received 20 May, 2020
Review #2 received
Received 14 May, 2020
Reviewer #4 agreed
On 03 May, 2020
Reviewer #3 agreed
On 28 Apr, 2020
Reviewer #2 agreed
On 24 Apr, 2020
Editor assigned
On 21 Apr, 2020
Reviewers invited
Invitations sent on 21 Apr, 2020
Reviewer #1 agreed
On 21 Apr, 2020
Submission checks complete
On 17 Apr, 2020
Editor invited
On 17 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Gastroenterology.
Background
Gastric cancer after Helicobacter pylori (HP) eradication is a crucial clinical challenge today as HP eradication therapy is widely performed. Detecting gastric cancer after HP eradication tends to be difficult with normal white-light endoscopy. In the present study, we aimed to identify easily-evaluated endoscopic findings that indicate the presence of gastric cancer after HP eradication so that endoscopists can consider additional detailed examinations at the site.
Methods
We analyzed the endoscopic images of 43 patients who underwent endoscopic submucosal dissection for early gastric cancer after HP eradication and 119 patients with an HP eradication history who underwent esophagogastroduodenoscopy for a medical checkup. Endoscopic findings were evaluated according to the Kyoto classification of gastritis (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) and map-like redness.
Results
Patients with gastric cancer had significantly higher total Kyoto risk scores; more atrophy, intestinal metaplasia, and diffuse redness; and a significantly higher prevalence of map-like redness compared with those without gastric cancer, in the univariate analyses. We used logistic regression analysis with forward selection based on the likelihood ratio to develop a model using atrophy and diffuse redness. Receiver operating characteristic analysis showed that a score of A2 in the Kyoto classification of gastritis (open-type atrophic pattern in the Kimura–Takemoto classification) was an endoscopic marker for the presence of post-HP-eradication gastric cancer.
Conclusions
Endoscopic severe gastric mucosal atrophy is useful to screen patients for gastric cancer after HP eradication.
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