Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis

Hiromitsu Kanzaki, Noriya Uedo, Ryu Ishihara, Kengo Nagai, Fumi Matsui, Takashi Ohta, Masao Hanafusa, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Hiroyasu Iishi, Yasuhiko Tomita, Masaharu Tatsuta, Kazuhide Yamamoto

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27 Citations (Scopus)

Abstract

Background: Barium radiographic studies have suggested the importance of evaluating areae gastricae pattern for the diagnosis of gastritis. Significance of endoscopic appearance of areae gastricae in the diagnosis of chronic atrophic fundic gastritis (CAFG) was investigated by image-enhanced endoscopy. Materials and Methods: Endoscopic images of the corpus lesser curvature were studied in 50 patients with CAFG. Extent of CAFG was evaluated with autofluorescence imaging endoscopy. The areae gastricae pattern was evaluated with 0.2% indigo carmine chromoendoscopy. Micro-mucosal structure was examined with magnifying chromoendoscopy and narrow band imaging. Results: In patients with small extent of CAFG, polygonal areae gastricae separated by a narrow intervening part of areae gastricae was observed, whereas in patients with wide extent of CAFG, the size of the areae gastricae decreased and the width of the intervening part of areae gastricae increased (p<0.001). Most areae gastricae showed a foveola-type micro-mucosal structure (82.7%), while intervening part of areae gastricae had a groove-type structure (98.0%, p<0.001). Groove-type mucosa had a higher grade of atrophy (p<0.001) and intestinal metaplasia (p<0.001) compared with foveola type. Conclusions: As extent of CAFG widened, multifocal groove-type mucosa that had high-grade atrophy and intestinal metaplasia developed among areae gastricae and increased along the intervening part of areae gastricae. Our observations facilitate our understanding of the development and progression of CAFG.

Original languageEnglish
Pages (from-to)224-231
Number of pages8
JournalHelicobacter
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 1 2012

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Keywords

  • Areae gastricae
  • Chronic atrophc fundic gastritis
  • Image enhanced endoscopy
  • Magnified endoscopy
  • Narrow band imaging

ASJC Scopus subject areas

  • Gastroenterology
  • Infectious Diseases

Cite this

Kanzaki, H., Uedo, N., Ishihara, R., Nagai, K., Matsui, F., Ohta, T., Hanafusa, M., Hanaoka, N., Takeuchi, Y., Higashino, K., Iishi, H., Tomita, Y., Tatsuta, M., & Yamamoto, K. (2012). Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis. Helicobacter, 17(3), 224-231. https://doi.org/10.1111/j.1523-5378.2012.00938.x