The Clinical Value Of Gastric Mucosal Appearance Under Gastroscopy In Judging H.pylori Infection

Objective Direct observation of gastric mucosal performance under gastroscopy to predict whether a patient is infected with H.pylori,and to explore its clinical judgment value.Methods Subjects who received both electronic gastroscopy and 13C-urea breath test were selected,of which 460 were included in the study.The gastroscopic physicians directly observed the gastric mucosal morphology under gastroscopy,and then directly determined the presence of H.pylori infection in subjects according to the standards of "Classification of Kyoto Gastritis",then the results were compared with the diagnostic standard of 13C-urea breath test.At the same time,the diagnostic power such as consistency rate,specificity,sensitivity,positive predictive value,negative predictive value and other related indicators of direct diagnosis of H.pylori infection under gastroscopy were be analyzed.Results Basic patient information: Among the 460 subjects,221 were males(48.04%)and 239 were females(51.96%).The age of the examinees was between 16 and 76 years old,and the average age was(47.45±11.44)years old.1.The 13C-urea breath test diagnosed H.pylori-positive subjects in 229 cases(49.78%),with 120 males(52.40%)and 109 females(47.60%).The age of the examinees was between 17 and 75 years old,and the average age was(48.31±11.27)years old.There were 231 patients(50.22%)were diagnosed as H.pylori-negative,the age of the examinees was between 16 and76 years old,and the average age was(46.60 ± 11.58)years old.H.pylori infection was compared with gender and age,and the difference was not statistically significant(P>0.05).2.Compared with the results of 13C-urea breath test,the study showed that the positive predictive value of H.pylori infection directly judged by gastroscopy was 72.32%,the negative predictive value was 71.61%,the consistency rate was 71.96%,the sensitivity was70.74%,and the specificity was 73.48%.3.Under gastroscopy,considering the endoscopic gastric mucosal manifestations that support H.pylori infection,the endoscopic manifestations of diffuse redness,spotty redness,atrophy,intestinal metaplasia,mucosal swelling,enlarged fold,tortuous fold,foveolar-hyperplastic polyp,white cloudy mucus,and depressive erosion were different between H.pylori infected and uninfected patients,with statistical significance(P<0.05).Considering the endoscopic gastric mucosal manifestations that did not support H.pylori infection,the endoscopic manifestations of RAC,hematin,fundic gland polyp,multiple white and flat elevated lesions,and red streak were different between H.pylori infected and uninfected patients,with statistical significance(P<0.05).However,there was no difference between the patients with H.pylori infection and those without H.pylori infection in terms of raised erosion,xanthoma and nodularity under gastroscopy,and the difference was not statistically significant(P>0.05).4.Compared with the results of 13C-urea breath test,the consistency rate of H.pylori infection determined by gastroscopy in the senior,medium and junior gastroscopic physician groups were 83.34%,70.45%,and 69.09%,respectively.The consistency rate of H.pylori infection diagnosed by gastroscopy in the group of senior gastroscopic physician was higher than that of the group of the medium and junior gastroscopic physician groups,the difference is statistically significant(P<0.05).Conclusion 1.Observing of the gastric mucosa of the subject under the endoscope directly has certain clinical value in judging H.pylori infection.2.The consistency rate of direct determination of patients with H.pylori infection by gastric mucosal morphology under gastroscopy is affected by the experience of endoscopists.