Relationship between histopathologic gastritis and mucosal microvascularity: observations with magnifying endoscopy

Background: The purpose of this study was to determine the usefulness of magnifying endoscopy for the diagnosis of Helicobacter pylori-induced histopathologic gastritis. Methods: A total of 92 patients scheduled to undergo routine endoscopic examination were enrolled. After routine endoscopic examination, 3 sites in the stomach were studied by magnified observation. Visualized collecting venulae were classified into the following 3 patterns: regular, irregular, and obscured. The sites observed by magnifying endoscopy were assessed histopathologically with an Updated Sydney System; 4 morphologic parameters (activity, inflammation, atrophy, metaplasia) were assessed and graded from 0 to 3. Results: The regular pattern cases were negative for H pylori infection at all sites observed by magnifying endoscopy (antrum greater curve, 0/11; body greater curve, 0/24; body lesser curve, 0/23). The scores for all 4 morphologic parameters were significantly lower in the regular pattern group than the irregular and obscured groups (p < 0.01). The value of the atrophy parameter in the irregular group was significantly higher than that in the obscured group (p < 0.05 for a single test of hypothesis; correction for multiple testing of data removed significance). Conclusion: Visibility of collecting venulae in the gastric mucosa is influenced by H pylori-induced histopathologic gastritis. Magnifying endoscopy is useful for the diagnosis of histopathologic gastritis.