Published online Sep 21, 2020. doi: 10.3748/wjg.v26.i35.5354
Peer-review started: May 7, 2020
First decision: May 15, 2020
Revised: May 17, 2020
Accepted: September 2, 2020
Article in press: September 2, 2020
Published online: September 21, 2020
Helicobacter pylori (H. pylori)-associated nodular gastritis could occur in both the antrum and the cardia. Cardiac nodularity-like appearance is found more frequently than antral nodularity.
Previous study included only the patients who were evaluated for H. pylori infection for the ﬁrst time. There still remains a lack of the prevalence and clinical features of cardiac nodularity-like appearance.
We aimed to evaluate the characteristics of cardiac nodularity-like appearance.
We enrolled consecutive patients who underwent esophagogastroduodenoscopy between May, 2017 and August, 2019 in the Toyoshima Endoscopy Clinic. We included H. pylori-negative, H. pylori-positive, and H. pylori-eradicated patients, and excluded patients with unclear H. pylori status and eradication failure. Cardiac nodularity was defined as a miliary nodular appearance or the presence of scattered whitish circular small colorations within 2 cm of the esophagogastric junction.
A total of 1078 patients were finally included. The prevalence of cardiac and antral nodularity in H. pylori-negative, -positive, and -eradicated patients were 0.14% and 0.14%, 54.5% and 29.5%, and 4.5% and 0.6%, respectively. Cardiac nodularity-like appearance was more frequent than antral nodularity in H. pylori-positive and -eradicated patients. Cardiac nodularity-like appearance was often found in younger patients and patients with less intestinal metaplasia. Cardiac nodularity-like appearance decreased after eradication, especially in patients who underwent eradication a long time ago.
This report outlines the prevalence and clinical features of cardiac nodularity-like appearance, and confirm its close association with active H. pylori infection.
Our results should be validated in diverse settings for generalizability.