Usefulness of Endoscopic Imaging to Visualize Regional Alterations in Acid Secretion of Noncancerous Gastric Mucosa after Helicobacter pylori Eradication.
Usefulness of Endoscopic Imaging to Visualize Regional Alterations in Acid Secretion of Noncancerous Gastric Mucosa after Helicobacter pylori Eradication.
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DOI：
10.5230/jgc.2016.16.3.152
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发表时间：
2016-09
影响因子：
2.5
通讯作者：
Shimosegawa T
中科院分区：
文献类型：
--
作者：
Uno K;Iijima K;Abe Y;Koike T;Takahashi Y;Ara N;Shimosegawa T
幽门螺杆菌根除后出现的胃癌(GC)的内窥镜诊断可能受到独特的形态变化的影响。以往的研究表明，刚果红染色内窥镜(CRE)可以清楚地显示具有恶性潜在性的酸性非分泌区(ANA)，而不注射药物或染色的自体荧光成像(AFI)可以早期发现或预测GC。我们的目的是确定AFI是否可以替代CRE来确定根除后胃癌发生的高危区域。我们纳入了27名在内窥镜监测中发现的异时性胃癌序贯患者，在根治性内窥镜切除和根治后平均82.8个月。在通过临床访谈和13C-尿素呼气试验评估他们的幽门螺杆菌感染状况后，将AFI和CRE之间的体部萎缩(例如开放型或闭合型萎缩)的范围的一致性作为主要终点进行调查。27例患者中有6例观察到AFI和CRE的萎缩延伸不一致，尽管CRE显示ANA中所有的GC病例。AFI在评估萎缩延伸方面的观察者间和观察者间的一致性显著低于CRE。我们证明，AFI检查结果可能不像CRE检查结果那样可靠，不能用于评估根除后具有恶性潜能的胃粘膜。因此，临床评估根除后背景胃粘膜的AFI表现时应特别注意(大学医院医学信息网络中心注册号：UMIN000020849)。
Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC. We aimed to determine whether AFI might be an alternative to CRE for identification of high-risk areas of gastric carcinogenesis after eradication. We included 27 sequential patients with metachronous GC detected during endoscopic surveillance for a mean of 82.8 months after curative endoscopic resection for primary GC and eradication. After their H. pylori infection status was evaluated by clinical interviews and 13C-urea breath tests, the consistency in the extension of corpus atrophy (e.g., open-type or closed-type atrophy) between AFI and CRE was investigated as a primary endpoint. Inconsistencies in atrophic extension between AFI and CRE were observed in 6 of 27 patients, although CRE revealed all GC cases in the ANA. Interobserver and intraobserver agreements in the evaluation of atrophic extension by AFI were significantly less than those for CRE. We demonstrated that AFI findings might be less reliable for the evaluation of gastric mucosa with malignant potential after eradication than CRE findings. Therefore, special attention should be paid when we clinically evaluate AFI findings of background gastric mucosa after eradication (University Hospital Medical Information Network Center registration number: UMIN000020849).
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影响因子：
7.6
作者：
Iijima, K;Sekine, H;Shimosegawa, T
通讯作者：
Shimosegawa, T
影响因子：
24.5
作者：
Osawa, H;Kita, H;Sugano, K
通讯作者：
Sugano, K
影响因子：
6.3
作者：
Shiotani, Akiko;Uedo, Noriya;Haruma, Ken
通讯作者：
Haruma, Ken
影响因子：
2.2
作者：
Iijima, Katsunori;Abe, Yasuhiko;Shimosegawa, Tooru
通讯作者：
Shimosegawa, Tooru
影响因子：
2.4
作者：
Miwata T;Quach DT;Hiyama T;Aoki R;Le HM;Tran PL;Ito M;Tanaka S;Arihiro K;Uemura N;Chayama K
通讯作者：
Chayama K