Regular arrangement of collecting venules and the Kimura-Takemoto classification for the endoscopic diagnosis of Helicobacter pylori infection: Evaluation in a Western setting
Regular arrangement of collecting venules and the Kimura-Takemoto classification for the endoscopic diagnosis of Helicobacter pylori infection: Evaluation in a Western setting
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集合小静脉的规则排列以及用于幽门螺杆菌感染内镜诊断的木村 - 竹本分类法：西方环境下的评估
DOI：
10.1111/den.13808
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发表时间：
2020-10-28
影响因子：
5.3
通讯作者：
Messmann, Helmut
中科院分区：
文献类型：
--
作者：
Ebigbo, Alanna;Marienhagen, Joerg;Messmann, Helmut
背景 集合小静脉的规则排列（RAC）和萎缩性改变的 Kimura-Takemoto 分类（KTC）是简单且易于使用的标准，已被证明可以可靠地预测或排除胃幽门螺杆菌感染。虽然这些特征在亚洲已被广泛研究，但其在西方的重要性尚未得到评估。 方法 在一系列连续 200 例胃镜检查（单检查者、单中心）中，前瞻性记录 RAC 的存在或不存在以及 KTC 分级（开放型与封闭型）。幽门螺杆菌感染被定义为组织学阳性或快速尿素酶试验阳性。此外，根据胃炎京都分类对幽门螺杆菌感染的内镜预测因子进行了多变量分析。结果对 200 名患者进行了检查，其中 57 例患有幽门螺杆菌感染（28%）。 RAC 和 KTC 均具有约 90% 的出色阴性预测值和高达 85% 的敏感度值。多因素分析显示，无RAC的萎缩性改变和弥漫性发红与H. pylori感染显着相关。结论 集合小静脉排列规则和KTC是简单的内镜特征，应引起西方内镜医师的重视，可轻松用于排除胃部H. pylori感染。
Background The regular arrangement of collecting venules (RAC) and the Kimura-Takemoto classification of atrophic change (KTC) are simple and easy-to-use criteria which have been shown to reliably predict or rule out a Helicobacter pylori infection of the stomach. Although these features have been investigated extensively in Asia, their significance in the West has not been evaluated.Methods In a series of 200 consecutive gastroscopic examinations (single examiner, single center), the presence or absence of RAC and the KTC grade (open type vs closed type) were recorded prospectively. Helicobacter pylori infection was defined as a positive histology or a positive rapid urease test. Furthermore, multivariate analysis of endoscopic predictors of H. pylori infection based on the Kyoto classification of gastritis was performed.Results Two hundred patients were examined of which 57 had a H. pylori infection (28%). Both RAC and KTC had excellent negative predictive values of about 90% and sensitivity values of up to 85%. In multivariate analysis, atrophic change and diffuse redness without RAC were significantly associated with H. pylori infection.Conclusion Regular arrangement of collecting venules and KTC are simple endoscopic features which should be given attention by Western endoscopists and can be easily used to rule out a H. pylori infection of the stomach.