• dog
• mitral valve plasty
• mucosal lesion
• myxomatous mitral valve disease
• narrowband imaging

• Animals
• Dogs
• Echocardiography, Transesophageal/veterinary
• Echocardiography, Transesophageal/adverse effects
• Dog Diseases/surgery
• Dog Diseases/diagnostic imaging
• Male
• Female
• Prospective Studies
• Mitral Valve/surgery
• Mitral Valve Insufficiency/veterinary
• Mitral Valve Insufficiency/surgery
• Esophagus/injuries
• Risk Factors

• Magnifying endoscopy
• Narrow band imaging
• Stomach neoplasms
• White globe appearance

• Humans
• Stomach Neoplasms/pathology
• Stomach Neoplasms/diagnostic imaging
• Female
• Male
• Middle Aged
• Retrospective Studies
• Aged
• Narrow Band Imaging/methods
• Gastroscopy/methods
• Adult
• Early Detection of Cancer/methods
• Aged, 80 and over
• Prospective Studies
• Gastric Mucosa/pathology
• Gastric Mucosa/diagnostic imaging

• API2/MALT1 fusion
• Endoscopy
• Helicobacter pylori
• MALT

• Humans
• Lymphoma, B-Cell, Marginal Zone/pathology
• Lymphoma, B-Cell, Marginal Zone/drug therapy
• Lymphoma, B-Cell, Marginal Zone/microbiology
• Lymphoma, B-Cell, Marginal Zone/genetics
• Male
• Female
• Helicobacter Infections/drug therapy
• Helicobacter Infections/pathology
• Middle Aged
• Retrospective Studies
• Helicobacter pylori/genetics
• Helicobacter pylori/drug effects
• Stomach Neoplasms/pathology
• Stomach Neoplasms/microbiology
• Stomach Neoplasms/drug therapy
• Oncogene Proteins, Fusion/genetics
• Treatment Outcome
• Aged
• Anti-Bacterial Agents/therapeutic use
• Adult
• Gastroscopy
• Gastritis/drug therapy
• Gastritis/microbiology
• Gastritis/pathology

• 2022YFC3602101 Key Technologies Research and Development Program

• H. pylori infection status
• Kyoto classification
• conventional white light endoscopy
• endoscopic appearance
• endoscopic models
• image‐enhanced endoscopy

• Acetic acid
• Endoscopic microanatomy
• Gastric mucosa
• Magnifying endoscopy
• Narrow-band imaging
• Near focus

• Helicobacter pylori
• cagA
• chronic gastritis
• gastric mucosa
• gastroduodenal disease
• inflammation
• peptic ulcer
• vacA

• Humans
• Bacterial Proteins/genetics
• Antigens, Bacterial/genetics
• Helicobacter pylori/genetics
• Virulence/genetics
• RNA, Ribosomal, 16S
• Retrospective Studies
• Gastritis/genetics
• Genotype
• Helicobacter Infections/complications
• Helicobacter Infections/genetics

• Gastric cancer
• Gastric dysplasia
• Helicobacter pylori
• Intestinal phenotype
• p53

• Carcinoma in Situ/pathology
• Female
• Gastric Mucosa/pathology
• Helicobacter Infections/pathology
• Helicobacter pylori
• Humans
• Hyperplasia/pathology
• Immunoglobulin D
• Intestinal Neoplasms/pathology
• Metaplasia/pathology
• Retrospective Studies
• Stomach Neoplasms/pathology

• Helicobacter pylori (H. pylori)
• Premalignant
• atrophic gastritis
• dysplasia
• endoscopy
• gastric adenocarcinoma
• intestinal metaplasia

• Helicobacter Infections/diagnosis
• Helicobacter pylori
• Humans
• ROC Curve
• Sensitivity and Specificity
• Venules

The sensitivity of regular arrangement of collecting venules (RAC)-positive pattern for predicting Helicobacter pylori (H. pylori)-negative status greatly altered from 93.8 to 48.0% in recent two decades of various studies, while the reason behind it remained obscure. The aim of this study was to investigate the value of RAC as an endoscopic feature for judging H. pylori status in routine endoscopy and reviewed the underlying mechanism.

A prospective study with high-definition non-magnifying endoscopy was performed. RAC-positive and RAC-negative patients were classified according to the collecting venules morphology of the lesser curvature in gastric corpus. Gastric biopsy specimens were obtained from the lesser and greater curvature of corpus with normal RAC-positive or abnormal RAC-negative mucosal patterns. Helicobacter pylori status was established by hematoxylin and eosin staining and immunohistochemistry.

41 RAC-positive and 124 RAC-negative patients were enrolled from June 2020 to September 2020. The prevalence of H. pylori infection in patients with RAC-positive pattern and RAC-negative pattern was 7.3% (3/41) and 71.0% (88/124), respectively. Among all 124 RAC-negative patients, 36 (29.0%) patients were H. pylori-negative status. Ten patients (32.3%) demonstrated RAC-positive pattern in 31 H. pylori-eradicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of RAC-positive pattern for predicting H. pylori-negative status were 51.4% (95% CI, 0.395–0.630), 96.7% (95% CI, 0.900–0.991), 92.7% (95% CI, 0.790–0.981), and 71.0% (95% CI, 0.620–0.786), respectively.

RAC presence can accurately rule out H. pylori infection of gastric corpus, and H. pylori-positive status cannot be predicted only by RAC absence in routine endoscopy.

Trial registration The present study is a non-interventional trial.

• Digestive system diagnostic techniques
• Gastric mucosa
• Gastrointestinal endoscopy
• Helicobacter pylori

Many studies evaluated magnification endoscopy (ME) to correlate changes on the gastric mucosal surface with Helicobacter pylori (H. pylori) infection. However, few studies validated these concepts with high-definition endoscopy without ME.

To access the association between mucosal surface pattern under near focus technology and H. pylori infection status in a western population.

Cross-sectional study including all patients referred to routine upper endoscopy. Endoscopic exams were performed using standard high definition (S-HD) followed by near focus (NF-HD) examination. Presence of erythema, erosion, atrophy, and nodularity were recorded during S-HD, and surface mucosal pattern was classified using NF-HD in the gastric body. Biopsies were taken for rapid urease test and histology.

One hundred and eighty-seven patients were analyzed from August to November 2019. Of those, 47 (25.1%) were H. pylori+, and 42 (22.5%) had a previous H. pylori treatment. In the examination with S-HD, erythema had the best sensitivity for H. pylori detection (80.9%). Exudate (99.3%), nodularity (97.1%), and atrophy (95.7%) demonstrated better specificity values, but with low sensitivity (6.4%-19.1%). On the other hand, the absence of erythema was strongly associated with H. pylori- (negative predictive value = 92%). With NF-HD, 56.2% of patients presented type 1 pattern (regular arrangement of collecting venules, RAC), and only 5.7% of RAC+ patients were H. pylori+. The loss of RAC presented 87.2% sensitivity for H. pylori detection, 70.7% specificity, 50% positive predictive value, and 94.3% negative predictive value, indicating that loss of RAC was suboptimal to confirm H. pylori infection, but when RAC was seen, H. pylori infection was unlikely.

The presence of RAC at the NF-HD exam and the absence of erythema at S-HD were highly predictive of H. pylori negative status. On the other hand, the loss of RAC had a suboptimal correlation with the presence of H. pylori.

• Diagnosis
• Endoscopy
• Gastric infection
• Gastritis
• Helicobacter pylori
• Sensitivity and specificity

• Atrophic Gastritis
• Best Practice
• Early Cancer Detection
• Endoscopy
• Gastric Cancer
• Gastric Intestinal Metaplasia
• Helicobacter pylori
• Screening
• Surveillance

Helicobacter pylori (H. pylori) infects approximately 50% of all humans globally. Persistent H. pylori infection causes multiple gastric and extragastric diseases, indicating the importance of early diagnosis and timely treatment. H. pylori eradication produces dramatic changes in the gastric mucosa, resulting in restored function. Consequently, to better understand the importance of H. pylori eradication and clarify the subsequent recovery of gastric mucosal functions after eradication, we summarize histological, endoscopic, and gastric microbiota changes to assess the therapeutic effects on the gastric mucosa.

• Helicobacter pylori
• Gastric mucosa
• Histology
• Endoscopic findings
• Gastrointestinal microbiota
• Eradication therapy

• Anti-Bacterial Agents/therapeutic use
• Gastric Mucosa
• Helicobacter Infections/drug therapy
• Helicobacter pylori
• Humans
• Microbiota
• Stomach

Helicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing area of research, as are their diagnostic accuracies. This study aimed to establish the diagnostic accuracy of several mucosal features predictive of H. pylori negative status and formulate a simple prediction model for use at the time of endoscopy.

Patients undergoing high-definition upper gastrointestinal (GI) endoscopy without magnification were recruited prospectively. During the endoscopy, the presence or absence of specific endoscopic findings was noted. Sydney protocol biopsies were used as the diagnostic reference standard, and urease test if taken. The results informed a logistic regression model used to produce a simple diagnostic approach. This model was subsequently validated using a further cohort of 30 patients.

153 patients were recruited and completed the study protocol. The prevalence of active H. pylori infection was 18.3% (28/153). The overall diagnostic accuracy of the simple prediction model was 80.0%, and 100% of patients with active H. pylori infection were correctly classified. The presence of regular arrangement of collecting venules (RAC) showed a positive predictive value for H. pylori naïve status of 90.7%, rising to 93.6% for patients under the age of 60.

A simple endoscopic model may be accurate for predicting H. pylori status of a patient, and the need for biopsy-based tests. The presence of RAC in the stomach is an accurate predictor of H. pylori negative status, particularly in patients under the age of 60.

The study was registered with ClinicalTrials.gov, No. NCT02385045.

• helicobacter pylori - assessment
• helicobacter pylori - gastritis
• helicobacter pylori infection

• Diagnosis
• Endoscopy
• Neoplasm
• Stomach

• artificial intelligence
• diagnosis of Helicobacter pylori
• endoscopy
• polymerase chain reaction

• Endoscopy
• Helicobacter pylori
• Proton pump inhibitors
• Regular arrangement of collecting venules

Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer. However, there are no comparative data on the utility of standard and magnifying narrow-band imaging (M-NBI) endoscopy for diagnosing Helicobacter pylori (H. pylori) infection, gastric atrophy, and intestinal metaplasia.

To compare the diagnostic performance of standard and M-NBI endoscopy for H. pylori gastritis and precancerous conditions.

In 254 patients, standard endoscopy findings were classified into mosaic-like appearance (type A), diffuse homogenous redness (type B), and irregular redness with groove (type C). Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci (type Z-1), more dilated and linear pits without sulci (type Z-2), and loss of gastric pits with coiled vessels (type Z-3).

The diagnostic accuracy of standard and M-NBI endoscopy for H. pylori gastritis was 93.3% and 96.1%, respectively. Regarding gastric precancerous conditions, the accuracy of standard and M-NBI endoscopy was 72.0% vs 72.6% for moderate to severe atrophy, and 61.7% vs. 61.1% for intestinal metaplasia in the corpus, respectively. Compared to type A and Z-1, types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy [odds ratio (OR) = 5.56 and 8.67] and serum pepsinogen I/II ratio of ≤ 3 (OR = 4.48 and 5.69).

Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H. pylori gastritis and precancerous conditions.

• Endoscopy
• Magnifying narrow-band imaging
• Helicobacter pylori
• Gastric atrophy
• Intestinal metaplasia
• Pepsinogen

• Gastric Mucosa/diagnostic imaging
• Gastroscopy
• Helicobacter Infections/diagnostic imaging
• Helicobacter pylori
• Humans
• Precancerous Conditions/diagnostic imaging
• Prospective Studies
• Stomach Neoplasms/diagnostic imaging

Atrophic gastritis is a precancerous gastric lesion, therefore its early detection is a priority in preventing gastric cancer. The aim of the present paper is to develop a narrative synthesis of the present knowledge on diagnostic methods of chronic atrophic gastritis.

A literature search was carried out on main databases: PubMed, Hinari, SpringerLink and Scopus (Elsevier) for the period 2000–2020. The searched keywords were: chronic atrophic gastritis, intestinal metaplasia and dysplasia + diagnosis. Inclusion criteria were focused on the articles about the invasive and non-invasive diagnosis of chronic atrophic gastritis and of precancerous gastric lesions, intestinal metaplasia and dysplasia; exclusion criteria were articles published before 2000 and those that did not include the proposed theme.

The search returned 575 papers addressing the topic of precancerous lesions. From these, 60 articles were qualified representative for the materials published on the topic of this synthesis article, being those that met the inclusion criteria. The data emphasize the need to use upper digestive endoscopy with biopsies for the diagnosis of chronic atrophic gastritis. However serological diagnosis is available as alternative mainly recommended in follow up.

There are two main methodological approaches for the evaluation of chronic atrophic gastritis as a precancerous gastric lesions: invasive examination, which requires histological analysis of biopsy samples taken during upper digestive endoscopy, being the “gold standard” for diagnosis, and non-invasive serological examination using markers of gastric function.

• Helicobacter pylori
• chronic atrophic gastritis
• gastric cancer

• Helicobacter pylori
• gastric foveolae
• gastrointestinal endoscopy
• regular arrangement of collecting venules

• Atrophic gastritis
• Gastric cancer
• Intestinal metaplasia
• Prevention
• Surveillance

The endoscopic findings associated with Helicobacter pylori–naïve status, current infection or past infection are an area of ongoing interest. Previous studies have investigated parameters with a potential diagnostic value. The aim of this study was to perform meta-analysis of the available literature to validate the diagnostic accuracy of mucosal features proposed in the Kyoto classification.

The databases of MEDLINE and Embase, clinicalTrials.gov and the Cochrane Library were systematically searched for relevant studies from October 1999 to October 2019.

A bivariate random effects model was used to produce pooled diagnostic accuracy calculations for each of the studied endoscopic findings. Diagnostic odds ratios and sensitivity and specificity characteristics were calculated to identify significant predictors of H pylori status.

Meta-analysis included 4380 patients in 15 studies. The most significant predictor of an H pylori-naïve status was a regular arrangement of collecting venules (diagnostic odds ratio 55.0, sensitivity 78.3%, specificity 93.8%). Predictors of active H pylori infection were mucosal oedema (18.1, 63.7%, 91.1%) and diffuse redness (14.4, 66.5%, 89.0%). Map-like redness had high specificity for previous H pylori eradication (99.0%), but poor specificity (13.0%).

The regular arrangement of collecting venules, mucosal oedema, diffuse redness and map-like redness are important endoscopic findings for determining H pylori status. This meta-analysis provides a tentative basis for developing future endoscopic classification systems.

• Helicobacter pylori
• gastritis
• image enhancement
• lesion recognition
• optical diagnosis

• Disposición regular de vénulas colectoras
• Helicobacter pylori
• Meta-analysis
• Metaanálisis
• Regular arrangement of collecting venules

• Gastroscopy
• Helicobacter pylori
• Humans
• Predictive Value of Tests
• Stomach/blood supply
• Stomach/pathology
• Venules

Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori (H. pylori) infection. The regular arrangement of collecting venules (RAC) is seen in the normal gastric corpus, whereas mucosal swelling and redness without RAC are observed in H. pylori-infected mucosa. Despite successful H. pylori eradication, the presence of atrophic gastritis and/or gastric intestinal metaplasia (GIM) is a risk factor for gastric cancer. With the development of advanced imaging technologies, recent studies have reported the usefulness of narrow-band imaging (NBI) for endoscopic diagnosis of atrophic gastritis and GIM. Using NBI endoscopy with magnification (M-NBI), atrophic gastritis is presented as irregular coiled microvessels and loss of gastric pits. Typical M-NBI endoscopic findings of GIM are a light blue crest and a white opaque substance. Based on the microvascular patterns, fine network, core vascular, and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions. For diagnosis of early gastric cancer (EGC), a systematic classification using M-NBI endoscopy has been proposed on the basis of the presence of a demarcation line and an irregular microvascular/microsurface pattern. Furthermore, M-NBI endoscopy has been found to be more accurate for determining the horizontal margin of EGC compared to conventional endoscopy. In this review, we present up-to-date results on the clinical usefulness of gastroscopy with NBI for the diagnosis of H. pylori gastritis, precancerous gastric lesion, and neoplasia.

• Gastroscopy
• Narrow-band imaging
• Magnification
• Helicobacter pylori
• Atrophic gastritis
• Intestinal metaplasia
• Dysplasia
• Cancer

• Helicobacter pylori
• diagnosis
• endoscopy
• eradication
• pepsinogen
• strategy

Accurate detection of gastric infection by Helicobacter pylori (H. pylori) and premalignant lesions are important for effective provision of treatment, preventing the development of gastric neoplasia. Optical enhancement systems with optical magnification improved the identification of mucosal superficial and vascular patterns in patients with dyspepsia.

To evaluate an optical enhancement system with high-definition magnification, for diagnosis of normal gastric mucosa, H. pylori-associated gastritis, and gastric atrophy.

A cross-sectional, nonrandomized study from November 2015 to April 2016 performed in a single-tertiary academic center from Ecuador. Seventy-two consecutive patients with functional dyspepsia according to the Rome III criteria, were tested for H. pylori using a stool antigen test and were assigned to an Hp⁺ group or an Hp⁻ control group. Esophagogastroduodenoscopy with high-definition optical magnification and digital chromoendoscopy was performed, and patients were classified into 4 groups, in accordance to the microvascular-architecture pattern of the mucosa. Interobserver and intraobserver agreement among operators were calculated.

Of the 72 participants, 35 were Hp⁺ and 37 were Hp⁻. Among 10 patients with normal mucosal histology in biopsy samples, 90% had a Type I pattern of microvascular architecture by endoscopy. Among participants with type IIa and type IIb patterns, significantly more were Hp⁺ than Hp⁻ (32 vs 8), and most (31 out of 40) had histological diagnoses of chronic active gastritis. Two of the three participants with a histological diagnosis of atrophy had a type III microvascular pattern. The type I pattern predicted normal mucosa, type IIa–IIb predicted H. pylori infection, and type III predicted atrophy with sensitivities of 90.0%, 91.4%, and 66.7%, respectively. The intraobserver and interobserver agreements had kappa values of 0.91 and 0.89, respectively.

High-definition optical magnification with digital chromoendoscopy is useful for diagnosis of normal gastric mucosa and H. pylori-associated gastritis with high accuracy, but further studies are needed to determine whether endoscopic diagnosis of gastric atrophy is feasible.

• Gastritis
• Helicobacter pylori
• Gastric mucosa
• Atrophic
• Endoscopy
• Digestive system

Mucosa-associated lymphoid tissue (MALT) lymphoma is the most common type of extra-nodal non-Hodgkin lymphoma, which mostly involves the stomach. The clinical suspicion and diagnosis are often challenging because of the lack of specific symptoms and conventional endoscopic findings. Three magnifying endoscopic signs of the gastric mucosa have been described as highly specific to the diagnosis of MALT lymphoma, such as (i) tree-like appearance of the microvessels; (ii) non-structural area; and (iii) ballooning crypt pattern. We report the case of a middle-aged woman in which these signs appeared chronologically over a period of 2 years, showing the association of the sequence of the endoscopic findings and the final histological diagnosis of gastric MALT lymphoma.

• B-Cell
• Endoscopy
• Lymphoma
• Marginal Zone

• Differential diagnosis
• Helicobacter pylori gastritis
• Linked-color imaging score

• Helicobacter pylori
• endoscopy
• intestinal metaplasia

• endoscopy
• gastric adenocarcinoma
• gastric pre-cancer
• gastritis
• helicobacter pylori-gastritis

• Adenocarcinoma/diagnosis
• Adenocarcinoma/microbiology
• Adenocarcinoma/surgery
• Biomarkers, Tumor/blood
• Disease Management
• Disease Progression
• Early Detection of Cancer/methods
• Evidence-Based Medicine/methods
• Gastritis, Atrophic/diagnosis
• Gastritis, Atrophic/microbiology
• Gastritis, Atrophic/surgery
• Gastroscopy/methods
• Helicobacter Infections/complications
• Helicobacter Infections/drug therapy
• Helicobacter pylori
• Humans
• Precancerous Conditions/diagnosis
• Precancerous Conditions/microbiology
• Precancerous Conditions/surgery
• Risk Assessment/methods
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/microbiology
• Stomach Neoplasms/surgery

• Helicobacter pylori
• atrophy
• intestinal metaplasia

• gastritis
• Endoscopy
• gastric atrophy
• intestinal metaplasia
• narrow band imaging
• serology
• white light endoscopy

• Adult
• Aged
• Aged, 80 and over
• Early Detection of Cancer
• Female
• Gastric Mucosa/pathology
• Gastritis, Atrophic/diagnostic imaging
• Gastritis, Atrophic/microbiology
• Gastritis, Atrophic/pathology
• Gastroscopy/methods
• Helicobacter Infections/complications
• Humans
• Male
• Middle Aged
• Narrow Band Imaging
• Observer Variation
• Precancerous Conditions/diagnostic imaging
• Precancerous Conditions/pathology
• Prospective Studies
• Sensitivity and Specificity
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/pathology
• United Kingdom
• Young Adult

• G0601170 Medical Research Council

Many studies have investigated risk factors other than antibiotic resistance linked to Helicobacter pylori (H. pylori) eradication failure. The aim of this study was to study the effect of serum levels of 25‐hydroxy‐vitamin D (25[OH]D) on eradication rates of H. pylori infection.

This study included 150 patients diagnosed with H. pylori gastritis using magnifying narrow‐band imaging endoscopy supported by stool antigen test. Serum 25‐OH vitamin D levels were measured via the Enzyme‐Linked Immune Sorbent assay (ELISA) method before starting eradication therapy of H. pylori infection. All patients were treated with clarithromycin‐based triple therapy for 14 days. H. pylori eradication was determined via a stool antigen test performed 4 weeks after the end of therapy. According to the serum level of 25‐OH vitamin D levels, the patients were divided into two groups: group I (sufficient) had a vitamin D level of ≥20 ng/mL, while group II (deficient) had a vitamin D level of <20 ng/mL.

Our results revealed that eradication was successful in 105 (70%) patients and failed in 45 (30%) patients. The mean 25[OH]D level was significantly lower in the eradication failure group compared to the successful treatment group (14.7 ± 4.5 vs 27.41 ± 7.1; P < 0.001). Furthermore, there were significantly more patients with deficient 25[OH]D levels in the failed treatment group, 30 (66.6%), compared to the successful group, 10 (9.5%) (P < 0.001).

Our results demonstrated that 25‐OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori infection. In addition, a further randomized trial to evaluate the effect of vitamin D supplementation in H. pylori eradication is mandatory.

• Helicobacter pylori eradication
• magnifying narrow band
• vitamin D

• endoscopy
• gastric cancer
• premalignant lesions

• Endoscopic diagnosis
• Helicobacter pylori
• deep convolutional neural network
• gastric carcinogenesis
• image-enhanced endoscopy

• diagnosis
• esophagogastroduodenoscopy
• gastric cancer
• magnifying narrow-band imaging
• screening endoscopy

• Artificial intelligence
• Convolutional neural networks
• Endoscopy
• Helicobacter pylori

• Artificial Intelligence
• Endoscopy, Gastrointestinal/methods
• Female
• Gastritis/diagnosis
• Gastritis/diagnostic imaging
• Gastritis/microbiology
• Helicobacter Infections/diagnosis
• Helicobacter Infections/diagnostic imaging
• Helicobacter Infections/microbiology
• Helicobacter pylori/isolation & purification
• Helicobacter pylori/pathogenicity
• Humans
• Image Processing, Computer-Assisted
• Male
• Middle Aged
• Neural Networks, Computer

Gastric diseases are common in China, and gastroduodenoscopy could provide accurate diagnoses. Our previous study verified that linked colour imaging (LCI) can improve endoscopic diagnostic accuracy. This study aimed for the first time to establish an LCI-based endoscopic model called colour-microstructure-vessel (CMV) criteria and validated its clinical feasibility for detecting distal gastric diseases manifested as red mucosal lesions under endoscopy in a cohort of 62 patients. Colour features were extracted from the endoscopic images and categorized into 3 types. Colour type 1 was a typical red; Colour type 2 was red ringed with purple and Colour type 3 was red with yellow in the centre and purple around the periphery, allowing for predicting chronic nonatrophic gastritis, chronic atrophic gastritis and gastric cancer. The sensitivity, specificity and Youden index of Colour type 3 with abnormal M or V for gastric cancer were 100.0%, 98.2% and 98.2%. The kappa values for intra-observer and inter-observer agreement for predicting the pathology were 0.834 and 0.791 for experienced endoscopists and 0.788 and 0.732 for endoscopy learners, and these values were comparable regardless of the experience of the endoscopists (P > 0.05). These findings support that the CMV criteria are a promising model for accurate endoscopic diagnosis.