Abstract
Objective: We investigated the status of H. pylori infection among endoscopic gastric cancer screening subjects according to the Kyoto classification of gastritis.
Methods: 460 subjects (251 males, mean age: 51.4 yrs.) who underwent upper endoscopic screening were included in our study. H. pylori-uninfected subjects were defined as having no gastric atrophy and visible RAC (regular arrangement of collecting venules) in the lesser curvature of the lower corpus, H. pylori-infected subjects as having diffuse redness and gastric atrophy, and H. pylori-past-infected subjects were defined as having gastric atrophy and no diffuse redness. Endoscopic gastric atrophy was diagnosed according to the Kimura-Takemoto classification.
Results: From the endoscopic findings, 295 subjects (64.1%) were diagnosed as H. pylori-uninfected, 50 (10.9%) as H. pylori-infected, and 115 (25%) as H. pylori-past-infected, based on the above definitions. The prevalence of H. pylori-uninfected subjects gradually decreased with age, while the prevalence of H. pylori-past-infected subjects gradually increased with age. In H. pylori-past-infected subjects, the prevalence of map-like redness was 22.6%, and this was accompanied by severe gastric atrophy.
Conclusions: The Kyoto classification of gastritis was very useful for determining the risk of gastric cancer. For patients with map-like redness after H. pylori eradication, it is very important to undergo regular endoscopic surveillance considering the possibility of developing gastric cancer.
