[Diagnostic value of endoscopic findings under white light gastroscopy for Helicobacter pylori infection in children]

Abstract

Objectives: To explore the clinical value of endoscopic findings under white light gastroscopy in diagnosing Helicobacter pylori (Hp) infection in children.

Methods: A retrospective analysis was conducted on the clinical data of 340 children who underwent gastroscopy and gastric mucosa tissue Hp culture from July 2022 to June 2023 in the Department of Gastroenterology at Wuxi Children's Hospital due to upper gastrointestinal symptoms. Based on the results of Hp culture, the children were categorized into an Hp-infected group (146 cases) and a non-infected group (194 cases). The detection rates of various endoscopic findings in the gastric mucosa between the two groups were compared, and the association between each endoscopic finding and different Hp infection statuses was analyzed, as well as the diagnostic value of each endoscopic finding under different Hp infection statuses.

Results: The proportions of white mucus, diffuse redness, mucosal edema, enlarged folds, chicken skin-like changes, and ulcers in the Hp-infected group were higher than those in the non-infected group (P<0.05), while the proportions of regular arrangement of collecting venules (RAC) and ridge-like redness were lower in the Hp-infected group compared to the non-infected group (P<0.05). Multivariate logistic regression analysis showed that diffuse redness, enlarged folds, mucosal edema, and chicken skin-like changes were closely associated with Hp infection (P<0.05), while RAC and ridge-like redness were closely associated with the absence of Hp infection (P<0.05). Receiver operating characteristic curve analysis indicated that the area under the curve for diffuse redness, enlarged folds, mucosal edema, and chicken skin-like changes in predicting Hp infection was 0.798, 0.731, 0.782, and 0.760, respectively (P<0.05). The area under the curve for RAC and ridge-like redness in predicting the absence of Hp infection was 0.861 and 0.589, respectively (P<0.05).

Conclusions: Endoscopic findings under white light gastroscopy are associated with Hp infection in children, with diffuse redness, mucosal edema, chicken skin-like changes, and enlarged folds showing significant diagnostic value for Hp infection.

Keywords: Child; Endoscopic finding; Helicobacter pylori; White light gastroscopy.

图1. 白光内镜下内镜征象 A：白色箭头所指为白色黏液；B：白色箭头所指条形充血带，为脊状发红；C：白色方圈内细点状静脉，为规则排列的集合细静脉；D：白色箭头所指蛇形隆起，为蛇形皱襞肿大；E：白色箭头所指黏膜凹陷，上覆白色分泌物，为十二指肠球部溃疡；F：胃体黏膜炎性发红，为黏膜弥漫性发红；G：胃体黏膜炎性水肿，为黏膜水肿；H：白色箭头所指片状充血，为黏膜片状发红；I：白色方圈内小颗粒样隆起，为胃窦部鸡皮样变。