Usefulness of vessel plus surface classification system for the diagnosis of early gastric cancer after Helicobacter pylori eradication

Masaki Miyaoka; Kenshi Yao; Hirhoshi Tanabe; Takao Kanemitsu; Kentaro Imamura; Yoichiro Ono; Kensei Ohtsu; Satoshi Ishikawa; Toshiki Kojima; Rino Hasegawa; Akikazu Hirano; Go Ikezono; Takashi Hisabe; Toshiharu Ueki; Atsuko Ota; Seiji Haraoka; Akinori Iwashita

Authors Masaki Miyaoka, Kenshi Yao, Hirhoshi Tanabe, Takao Kanemitsu, Kentaro Imamura, Yoichiro Ono, Kensei Ohtsu, Satoshi Ishikawa, Toshiki Kojima, Rino Hasegawa, Akikazu Hirano, Go Ikezono, Takashi Hisabe, Toshiharu Ueki, Atsuko Ota, Seiji Haraoka, Akinori Iwashita.

Abstract

Background It has been reported that it is sometimes difficult to make a diagnosis of gastric cancer detected after Helicobacter pylori (H. pylori) eradication. Therefore, we conducted a study to determine the usefulness of magnifying endoscopy using vessel plus surface classification system for making a diagnosis of early gastric cancer after H. pylori eradication.

Method Usefulness of the markers of the vessel plus surface classification system for diagnosing gastric cancer using magnifying endoscopy with narrow-band imaging was investigated for gastric cancer detected after H. pylori eradication (H. pylori-eradicated group) vs. H. pylori-positive gastric cancer (H. pylori-positive group).

Results 85 lesions were included in this study. The H. pylori-eradicated group comprised 27 lesions, whereas the H. pylori-positive group comprised 58 lesions. As for magnified endoscopic findings based on the vessel plus surface classification system, the respective positivity rates in the H. pylori-eradicated group vs. those in the H. pylori-positive group were as follows: demarcation line, 100% (27/27) vs. 100% (58/58); irregular microvascular pattern, 100% (27/27) vs. 100% (58/58); and irregular microsurface pattern, 78% (21/27) vs. 95% (55/58). There was no significant difference in the positivity rates of the demarcation line and irregular microvascular pattern between the groups. The positivity rate of the irregular microsurface pattern was significantly lower in the H. pylori-eradicated group than in the H. pylori-positive group (P=0.03).

Conclusion We presume that the microvascular pattern is more useful than the microsurface pattern as a diagnostic marker in cases of gastric cancer detected after H. pylori eradication.

Keywords Helicobacter pylori, eradication, gastric cancer, magnifying endoscopy, vessel plus surface classification

Ann Gastroenterol 2021; 34 (3): 354-360