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Yuan C, Lin XM, Ou Y, Cai L, Cheng Q, Zhou P, Liao J. Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy. BMC Gastroenterol 2021; 21:389. [PMID: 34670510 PMCID: PMC8527606 DOI: 10.1186/s12876-021-01960-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 10/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background The sensitivity of regular arrangement of collecting venules (RAC)-positive pattern for predicting Helicobacter pylori (H. pylori)-negative status greatly altered from 93.8 to 48.0% in recent two decades of various studies, while the reason behind it remained obscure. The aim of this study was to investigate the value of RAC as an endoscopic feature for judging H. pylori status in routine endoscopy and reviewed the underlying mechanism. Methods A prospective study with high-definition non-magnifying endoscopy was performed. RAC-positive and RAC-negative patients were classified according to the collecting venules morphology of the lesser curvature in gastric corpus. Gastric biopsy specimens were obtained from the lesser and greater curvature of corpus with normal RAC-positive or abnormal RAC-negative mucosal patterns. Helicobacter pylori status was established by hematoxylin and eosin staining and immunohistochemistry. Results 41 RAC-positive and 124 RAC-negative patients were enrolled from June 2020 to September 2020. The prevalence of H. pylori infection in patients with RAC-positive pattern and RAC-negative pattern was 7.3% (3/41) and 71.0% (88/124), respectively. Among all 124 RAC-negative patients, 36 (29.0%) patients were H. pylori-negative status. Ten patients (32.3%) demonstrated RAC-positive pattern in 31 H. pylori-eradicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of RAC-positive pattern for predicting H. pylori-negative status were 51.4% (95% CI, 0.395–0.630), 96.7% (95% CI, 0.900–0.991), 92.7% (95% CI, 0.790–0.981), and 71.0% (95% CI, 0.620–0.786), respectively. Conclusions RAC presence can accurately rule out H. pylori infection of gastric corpus, and H. pylori-positive status cannot be predicted only by RAC absence in routine endoscopy. Trial registration The present study is a non-interventional trial.
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Affiliation(s)
- Cong Yuan
- Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Xue-Mei Lin
- Department of Pathology, Basic Medical College of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.,Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China
| | - Yan Ou
- Department of Gastroenterology, West China Forth Hospital, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Lin Cai
- Department of Gastroenterology, West China Forth Hospital, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Qian Cheng
- Department of Gastroenterology, West China Forth Hospital, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Ping Zhou
- Department of Pathology, West China Forth Hospital, West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Juan Liao
- Department of Gastroenterology, West China Forth Hospital, West China School of Public Health, Sichuan University, Chengdu, 610041, China. .,Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, 610041, China.
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Yuan C, Lin XM, Ou Y, Cheng Q, Cai L, Zhou P, Liao J. Gastric foveolar elongation causes invisibility of regular arrangement of collecting venules in chronic active and inactive gastritis. Helicobacter 2021; 26:e12770. [PMID: 33185317 DOI: 10.1111/hel.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Helicobacter pylori (H pylori) infection is the most common cause of gastritis. The disappearance of regular arrangement of collecting venules (RAC) is well known as one of the main manifestations of H pylori-affected gastritis while the reason behind it remains obscure. The aim of this study was to investigate the relationship between invisibility of RAC and the length of gastric foveolae. METHODS 43 RAC-positive and 118 RAC-negative patients were enrolled. Gastric biopsy specimens were obtained from lesser and greater curvature of the corpus with RAC-positive or RAC-negative pattern. Histopathological evaluation was performed based on the updated Sydney System, and foveolar length was derived by a morphometric technique. RESULTS The median gastric foveolar length in RAC-positive group (median [IQR], 138.54 μm [120.50, 159.09]) was significantly shorter than that in the RAC-negative group (median [IQR], 260.96 μm [217.40, 315.23], P < .05). The length of gastric foveolae in chronic active gastritis (RAC-negative, activity grades 1, 2, and 3) and inactive gastritis (RAC-negative, activity grade 0) was longer than that in normal group (RAC-positive, activity grade 0) (P < .05). The optimal cutoff value for gastric foveolae length of the corpus mucosa showing RAC-negative pattern was more than 181.53 μm. The sensitivity and specificity of more than cutoff value for predicting the invisibility of RAC were 93.03% and 91.78%, respectively. CONCLUSIONS The elongation of gastric foveolae caused the invisibility of RAC in gastric corpus mucosa in chronic active and inactive gastritis on gastroendoscopy.
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Affiliation(s)
- Cong Yuan
- Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xue-Mei Lin
- Department of Pathology, Basic Medical College of North Sichuan Medical College, Nanchong, China.,Department of Pathology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yan Ou
- Department of Gastroenterology, West China School of public health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Qian Cheng
- Department of Gastroenterology, West China School of public health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Lin Cai
- Department of Gastroenterology, West China School of public health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Ping Zhou
- Department of Pathology, West China School of public health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Juan Liao
- Department of Gastroenterology, West China School of public health, West China Forth Hospital, Sichuan University, Chengdu, China
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Particular Morphological Features in the Diagnosis of Pediatric Helicobacter pylori Gastritis: A Morphometry-Based Study. J Clin Med 2020; 9:jcm9113639. [PMID: 33198263 PMCID: PMC7696087 DOI: 10.3390/jcm9113639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Current pediatric guidelines recommend the use of the Updated Sydney Classification for gastritis to assess histological changes caused by Helicobacter pylori (H. pylori) infection. The purpose of this study was to investigate the morphometric alterations of the antral mucosa in relation to pediatric H. pylori infection. Methods: A total of 65 cases were considered eligible. Apart from scoring the biopsies according to the recommendations, foveolar hyperplasia (FH) was assessed. The following measurements were performed on digital slides: total mucosal thickness, foveolar and glandular length, number of glandular cross sections per 40X field, glandular diameter, and distance between glands. Results: The thickness of the antral mucosa increased along with the bacterial density and the intensity of inflammation in H. pylori-infected children (p < 0.05). FH was significantly associated with the presence of H. pylori (p < 0.001) and also exhibited a greater length of the foveolar and glandular structures and an increased glandular diameter (p < 0.05), but without influencing the thickness of the mucosa. Conclusions: Our results reinforce the fact that FH is not only an important histologic characteristic of gastropathy, but is also a significant change observed in H. pylori infection in children and may be considered for reporting when evaluating pediatric gastric biopsies.
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