Risk of map-like redness development after eradication therapy for Helicobacter pylori infection

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Helicobacter Pub Date : 2024-01-24 DOI:10.1111/hel.13046

Sho Matsumoto, Mitsushige Sugimoto, Masakatsu Fukuzawa, Nana Uesugi, Eri Iwata, Yasuyuki Kagawa, Akira Madarame, Yohei Koyama, Takashi Morise, Kumiko Uchida, Hayato Yamaguchi, Shin Kono, Sakiko Naito, Takashi Kawai, Takao Itoi

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Abstract

Background

Map-like redness is a newly identified endoscopic risk factor for gastric cancer in patients who received Helicobacter pylori eradication therapy. However, the incidence rate of map-like redness in patients who received eradication, and the risk factors for the development of map-like redness remain unclear. We hence aimed to investigate the incidence rate of map-like redness at 1-year post H. pylori eradication, and evaluated its associations with map-like redness and gastric cancer in relation with gastric condition.

Materials and Methods

Endoscopic severity of gastritis and map-like redness were retrospectively evaluated according to the Kyoto Classification of Gastritis in patients who had undergone endoscopy before and after H. pylori eradication therapy.

Results

The incidence rate of map-like redness for all 328 patients at a mean of 1.2 ± 0.6 years after eradication was 25.3% (95% confidence interval [CI]: 20.7%–30.4%). Patients who developed map-like redness were older, had more severe atrophy and intestinal metaplasia, a higher total score of the Kyoto Classification of Gastritis both before and after eradication, and a higher rate of gastric cancer history than patients who did not have map-like redness. On multivariate analysis, risk of map-like redness was increased in patients with intestinal metaplasia (odds ratio [OR]: 2.794, 95% CI: 1.155–6.757) and taking acid inhibitors (OR: 1.948, 95% CI: 1.070–3.547). Characteristics of H. pylori-positive patients with gastric cancer history were patients who were older (OR: 1.033, 95% CI: 1.001–1.066), taking acid inhibitors (OR: 4.456, 95% CI: 2.340–8.484), and with occurrence of map-like redness after eradication therapy (OR: 2.432, 95% CI: 1.264–4.679).

Conclusions

Map-like redness is observed in one fourth of patients at 1-year post eradication. Patients who developed map-like redness were found to have severe intestinal metaplasia and taking acid inhibitors, and hence such patients require increased attention at surveillance endoscopy.

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幽门螺杆菌感染根除疗法后出现地图样红斑的风险

背景地图样发红是新发现的接受幽门螺杆菌根除治疗的患者患胃癌的内镜风险因素。然而，接受根除治疗的患者中地图样发红的发生率以及发生地图样发红的风险因素仍不清楚。因此，我们旨在调查幽门螺杆菌根除后 1 年的地图样发红发生率，并评估其与地图样发红和胃癌的相关性。材料和方法根据京都胃炎分类法，对幽门螺杆菌根除治疗前后接受内镜检查的患者的内镜下胃炎严重程度和地图样发红进行回顾性评估。结果在根除幽门螺杆菌后平均 1.2 ± 0.6 年的时间里，所有 328 名患者的地图样发红发生率为 25.3%（95% 置信区间 [CI]：20.7%-30.4%）。与未出现地图样发红的患者相比，出现地图样发红的患者年龄更大，萎缩和肠化生更严重，根除前后的京都胃炎分类总分更高，胃癌病史率更高。多变量分析显示，肠化生（几率比 [OR]：2.794，95% CI：1.155-6.757）和服用胃酸抑制剂（OR：1.948，95% CI：1.070-3.547）的患者出现地图样发红的风险增加。有胃癌病史的幽门螺杆菌阳性患者的特征是年龄较大（OR：1.033，95% CI：1.001-1.066）、服用酸抑制剂（OR：4.456，95% CI：2.340-8.484）、根除治疗后出现地图样发红（OR：2.432，95% CI：1.264-4.679）。结论四分之一的患者在根除治疗 1 年后出现地图样发红。发现出现地图样发红的患者有严重的肠化生，并正在服用酸抑制剂，因此这类患者需要在监测内镜检查时给予更多关注。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.