Endoscopic patterns of gastric mucosa and its clinicopathological significance

AIM: To explore the correlation of magnifying endoscopic patterns and histopathology, Helicobacter pylori(H pylori) infection of the gastric mucosa. METHODS: Gastric mucosal patterns in 140 patients with chronic gastritis were studied using Olympus GIF-Q240Z magnifying endoscope. Histopathological examination, rapid urease test and Warrthin-Starry staining were taken with biopsy samples from the magnified sites of stomach. The magnifying endoscopic patterns were compared with histopathological results and H pylori detection. RESULTS: The pit patterns of gastric mucosa were classified as types A (round spot), B (short rod), C (branched), D (reticular) and E (villus). The detection rate of chronic atrophic gastritis (CAG) by magnifying endoscopy was 94.3 % (33/35), which was significantly higher than that by routine endoscopy (22.9 %, 8/35) (P<0.01). The pit patterns of 31 cases of intestinal metaplasia (IM) appeared as type E in 18 cases (58.1 type D in 8 cases (25.8 %) and type C in 5 cases (16.1 %). Fourteen out of 18 patients (77.8 %) with complete type (type I) of IM appeared as type E of pit patterns, whereas only 4 of 13 (30.8 %) patients with incomplete type (types II and III) of IM appeared as type E (P<0.05). Collecting venules in the anterior of lower part of gastric corpus were subgrouped into types R (regular), I (irregular) and D (disappeared). H pylori infection was found in 12.2 %(9/74), 60 %(9/15) and 84.3 %(43/51) cases in these types respectively. H pylori infection rate in type R was significantly lower than that in other two types (P<0.01). CONCLUSION: Magnifying endoscopy may have an obvious value in diagnosing chronic atrophic gastritis, intestinal metaplasia and H pylori infection.