AUTHOR=Luo Xin , Li Hui , He Li 

TITLE=Correlation analysis of endoscopic manifestations and eradication effect of Helicobacter pylori

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1259728

DOI=10.3389/fmed.2023.1259728

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p><italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infection is the most important risk factor for gastric cancer. Eradication of <italic>H. pylori</italic> significantly reduces the incidence and mortality of gastric cancer. <italic>H. pylori</italic> resistance to antibiotics and a gradual decline in eradication rates are gaining more and more attention. Our study aimed to address the correlation between endoscopic manifestations and the eradication effect of <italic>H. pylori</italic>.</p></sec><sec><title>Methods</title><p>We retrospectively reviewed outpatients in our hospital with <italic>H. pylori</italic> infection undergoing eradication therapy from January 2022 to March 2023. Both the primary diagnosis and eradication of <italic>H. pylori</italic> after treatment were confirmed by a <sup>13</sup>C urea breath test. Patients were treated with a proton pump inhibitor (PPI)-based quadruple therapy. Clinical characteristics and endoscopy manifestations within 7 days before or after patients were diagnosed with <italic>H. pylori</italic> infection were analyzed.</p></sec><sec><title>Results</title><p>From January 2022 to March 2023, a total of 323 patients were enrolled in this study. There were 138 male patients and 185 female patients. The mean age of patients was 45.62 ± 13.04 years. The <italic>H. pylori</italic> initial eradication rate was 82.0%. Univariate analysis of factors affecting <italic>H. pylori</italic> eradication showed that sex, age, and endoscopic manifestations including diffuse redness, multiple white, and flat elevated lesions, and atrophy were significantly associated with the failure of <italic>H. pylori</italic> eradication therapy. A multivariable logistic regression model analysis of these five factors showed that patients aged over 60 years with multiple white and flat elevated lesions in the endoscopic examination are significantly less likely to eradicate <italic>H. pylori</italic> with empirical quadruple therapy. On the other hand, patients with diffuse redness were significantly more likely to eradicate <italic>H. pylori</italic> infection with empirical quadruple therapy.</p></sec><sec><title>Conclusion</title><p>Our study shows that age over 60 years old, multiple white and flat elevated lesions in endoscopic examination are independent risk factors of initial <italic>H. pylori</italic> eradication failure with empirical quadruple therapy, while diffuse redness in endoscopic examination is a protective factor of initial <italic>H. pylori</italic> eradication failure with empirical quadruple therapy, while diffuse redness in endoscopic examination is a protective factor. For patients with these risk factors, a drug sensitivity test or <italic>H. pylori</italic> resistance gene mutation detection may be more appropriate. However, further mechanism studies or prospective studies are needed to prove our findings.</p></sec>