Linked color imaging identifies important risk factors associated with gastric cancer after successful eradication of Helicobacter pylori

Abstract

Limited studies have evaluated the risk factors of gastric cancer (GC) after eradication of Helicobacter pylori (H pylori) using endoscopic findings. We aimed to investigate GC detection-related endoscopic findings after eradication of H pylori using linked color imaging (LCI), a novel image-enhanced endoscopy. This single-center, cross-sectional study evaluated background mucosa-associated endoscopic findings described in the Kyoto classification of gastritis in patients with newly detected GC after eradication of H pylori (CA group, n= 109) and those without GC (NC group, n= 85) using white-light imaging (WLI) and LCI. Severe atrophy and map-like redness were significantly more frequent in the CA group than in the NCgroup using WLI (79.8% vs 63.5%, P= .01; 61.5% vs 37.7%, P= .001, respectively) and LCI (79.8% vs 63.5%, P= .01; 78.0% vs 45.9%, P< .0001, respectively). Regular arrangement of collecting venules (RAC) was significantly less frequent in the CA group than in the NC group using WLI (40.3% vs 64.7%, P= .0009) and LCI (37.6% vs 62.4%, P= .0006). Map-like redness was an independent positive risk factor (WLI: odds ratio [OR], 2.05; 95% confidence interval [CI], 1.09-3.87; P= .03; LCI: OR, 3.62; 95% CI, 1.88-6.97; P< .001), whereas RAC was an independent negative risk factor (WLI: OR, 0.42; 95% CI, 0.21-0.82; P= .01; LCI: OR, 0.46; 95% CI, 0.23-0.93, P= .03) for detection of GC after eradication of H pylori. Map-like redness, which was identified more frequently using LCI than WLI, and the absence of RAC were associated with detection of GC after eradication of H pylori.