Article ID: 24015
Objective: This study aimed to identify the quality indicators of examination associated with the detection of gastric cancer after Helicobacter pylori (H. pylori) eradication.
Subjects and Methods: A total of 22,978 screening endoscopies were performed between July 2020 and January 2022. We randomly selected endoscopic images from 25 uninfected and 25 eradicated cases examined by nine endoscopists who detected gastric cancer after H. pylori eradication and seven endoscopists who did not detect any during the study period. The former group was defined as the detection group (225 uninfected and 225 eradicated cases), and the latter as the non-detection group (175 uninfected and 175 eradicated cases). Cases with post-surgical stomach, chromoendoscopy, and biopsies were excluded. We evaluated the Kyoto classification of gastric cancer risk scores, intragastric observation time, upper-middle (UM) region observation time, lower (L) region observation time, narrow band imaging (NBI) usage rate in the L region, and the sites of imaging.
Results: In H. pylori-eradicated cases, the detection group had a significantly higher imaging rate of the posterior wall of the lower body. Only in the detection group were intragastric observation time, UM region observation time, L region observation time, and NBI usage rate significantly higher in eradicated cases compared to uninfected cases. In the non-detection group, intragastric observation time and UM region observation time were significantly higher in cases with a Kyoto classification gastric cancer risk score of 2 points or higher. Additionally, in the detection group, L region observation time and NBI usage rate were also significantly higher.
Conclusion: Careful observation using NBI in atrophic and intestinal metaplasia-associated regions contributes to the detection of gastric cancer after H. pylori eradication.
