Abstract Objective To explore the clinical value of endoscopic findings under white light gastroscopy in diagnosing Helicobacter pylori (Hp) infection in children. Methods A retrospective analysis was conducted on the clinical data of 340 children who underwent gastroscopy and gastric mucosa tissue Hp culture from July 2022 to June 2023 in the Department of Gastroenterology at Wuxi Children's Hospital due to upper gastrointestinal symptoms. Based on the results of Hp culture, the children were categorized into an Hp-infected group (146 cases) and a non-infected group (194 cases). The detection rates of various endoscopic findings in the gastric mucosa between the two groups were compared, and the association between each endoscopic finding and different Hp infection statuses was analyzed, as well as the diagnostic value of each endoscopic finding under different Hp infection statuses. Results The proportions of white mucus, diffuse redness, mucosal edema, enlarged folds, chicken skin-like changes, and ulcers in the Hp-infected group were higher than those in the non-infected group (P<0.05), while the proportions of regular arrangement of collecting venules (RAC) and ridge-like redness were lower in the Hp-infected group compared to the non-infected group (P<0.05). Multivariate logistic regression analysis showed that diffuse redness, enlarged folds, mucosal edema, and chicken skin-like changes were closely associated with Hp infection (P<0.05), while RAC and ridge-like redness were closely associated with the absence of Hp infection (P<0.05). Receiver operating characteristic curve analysis indicated that the area under the curve for diffuse redness, enlarged folds, mucosal edema, and chicken skin-like changes in predicting Hp infection was 0.798, 0.731, 0.782, and 0.760, respectively (P<0.05). The area under the curve for RAC and ridge-like redness in predicting the absence of Hp infection was 0.861 and 0.589, respectively (P<0.05). Conclusions Endoscopic findings under white light gastroscopy are associated with Hp infection in children, with diffuse redness, mucosal edema, chicken skin-like changes, and enlarged folds showing significant diagnostic value for Hp infection.
ZHOU Ren-Min,CHEN Ying,LIN Qiong. Diagnostic value of endoscopic findings under white light gastroscopy for Helicobacter pylori infection in children[J]. CJCP, 2025, 27(4): 438-443.
ZHOU Ren-Min,CHEN Ying,LIN Qiong. Diagnostic value of endoscopic findings under white light gastroscopy for Helicobacter pylori infection in children[J]. CJCP, 2025, 27(4): 438-443.
Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis[J]. Gastroenterology, 2017, 153(2): 420-429. PMID: 28456631. DOI: 10.1053/j.gastro.2017.04.022.
Seo JH, Bortolin K, Jones NL. Review: Helicobacter pylori infection in children[J]. Helicobacter, 2020, 25Suppl 1:e12742. PMID: 32918353. DOI: 10.1111/hel.12742.
Sakae H, Iwamuro M, Okamoto Y, et al. Evaluation of the usefulness and convenience of the Kyoto classification of gastritis in the endoscopic diagnosis of the Helicobacter pylori infection status[J]. Digestion, 2020, 101(6): 771-778. PMID: 31536988. DOI: 10.1159/000502573.
Calvet X, Ramírez Lázaro MJ, Lehours P, et al. Diagnosis and epidemiology of Helicobacter pylori infection[J]. Helicobacter, 2013, 18 Suppl 1: 5-11. PMID: 24011238. DOI: 10.1111/hel.12071.
Yoshii S, Mabe K, Watano K, et al. Validity of endoscopic features for the diagnosis of Helicobacter pylori infection status based on the Kyoto classification of gastritis[J]. Dig Endosc, 2020, 32(1): 74-83. PMID: 31309632. DOI: 10.1111/den.13486.
Shiotani A, Kamada T, Kumamoto M, et al. Nodular gastritis in Japanese young adults: endoscopic and histological observations[J]. J Gastroenterol, 2007, 42(8): 610-615. PMID: 17701123. DOI: 10.1007/s00535-007-2073-5.
Hojo M, Nagahara A, Kudo T, et al. Endoscopic findings of Helicobacter pylori gastritis in children and young adults based on the Kyoto classification of gastritis and age-associated changes[J]. JGH Open, 2021, 5(10): 1197-1202. PMID: 34622008. PMCID: PMC8485397. DOI: 10.1002/jgh3.12652.
Mao T, Wang Y, Yin F, et al. Association of endoscopic features of gastric mucosa with Helicobacter pylori infection in Chinese patients[J]. Gastroenterol Res Pract, 2016, 2016: 6539639. PMID: 27974885. PMCID: PMC5128703. DOI: 10.1155/2016/6539639.
Yagi K, Nakamura A, Sekine A. Characteristic endoscopic and magnified endoscopic findings in the normal stomach without Helicobacter pylori infection[J]. J Gastroenterol Hepatol, 2002, 17(1): 39-45. PMID: 11895551. DOI: 10.1046/j.1440-1746.2002.02665.x.
Ebigbo A, Marienhagen J, Messmann H. Regular arrangement of collecting venules and the Kimura-Takemoto classification for the endoscopic diagnosis of Helicobacter pylori infection: evaluation in a Western setting[J]. Dig Endosc, 2021, 33(4): 587-591. PMID: 32767790. DOI: 10.1111/den.13808.
Garcés-Durán R, García-Rodríguez A, Córdova H, et al. Association between a regular arrangement of collecting venules and absence of Helicobacter pylori infection in a European population[J]. Gastrointest Endosc, 2019, 90(3): 461-466. PMID: 31108089. DOI: 10.1016/j.gie.2019.05.027.