Published online May 7, 2023. doi: 10.3748/wjg.v29.i17.2657
Peer-review started: February 8, 2023
First decision: February 16, 2023
Revised: March 3, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 7, 2023
Processing time: 88 Days and 3.5 Hours
Mucosal patterns (MPs) observed on blue laser imaging in patients with atrophic gastritis can be classified as spotty, cracked, and mottled. Furthermore, we hypothesized that the spotty pattern may change to the cracked pattern after Helicobacter pylori (H. pylori) eradication.
To further substantiate and comprehensively investigate MP changes after H. pylori eradication in a larger number of patients.
We included 768 patients who were diagnosed with atrophic gastritis with evaluable MP using upper gastrointestinal endoscopy at the Nishikawa Gas-trointestinal Clinic, Japan. Among them, 325 patients were H. pylori-positive, and of them, 101 patients who underwent upper gastrointestinal endoscopy before and after H. pylori eradication were evaluated for post-eradication MP changes. The patients’ MPs were interpreted by three experienced endoscopists who were blinded to their clinical features.
Among 76 patients with the spotty pattern before or after H. pylori eradication, the pattern disappeared or decreased in 67 patients [88.2%, 95% confidence interval (CI): 79.0%-93.6%), appeared or increased in 8 patients (10.5%, 95%CI: 5.4%-19.4%), and showed no change in 1 patient (1.3%, 95%CI: 0.2%-7.1%). In 90 patients with the cracked pattern before or after H. pylori eradication, the pattern disappeared or decreased in 7 patients (7.8%, 95%CI: 3.8%-15.2%), appeared or increased in 79 patients (87.8%, 95%CI: 79.4%-93.0%), and showed no change in 4 patients (4.4%, 95%CI: 1.7%-10.9%). In 70 patients with the mottled pattern before or after H. pylori eradication, the pattern disappeared or decreased in 28 patients (40.0%, 95%CI: 29.3%-51.7%), appeared or increased in 35 patients (50.0%, 95%CI: 38.6%-61.4%), and showed no change in 7 patients (10.0%, 95%CI: 4.9%-19.2%).
After H. pylori eradication, MPs changed from spotty to cracked in most patients, which may help endoscopists easily and precisely evaluate H. pylori-related gastritis status.
Core Tip: We investigated whether the mucosal patterns on blue laser imaging may change from spotty to cracked after Helicobacter pylori (H. pylori) eradication. The spotty pattern disappeared or decreased in 88.2% of patients, while the cracked pattern appeared or increased in 87.8% of patients. These suggest that the spotty pattern observed in H. pylori-positive patients is likely to disappear after eradication and may be replaced by the cracked pattern. These observations may help endoscopists easily and precisely evaluate H. pylori-related gastritis status.