摘要
Abstract
Objective:To validate the application value of Kyoto gastritis score in diagnosing Helicobacter pylori(Hp)infection status under gastroscopy in Chinses population,and to construct a modified prediction model to improve the diagnostic value of Hp infection.Methods:A total of 749 cases who underwent gastroscopy at the Digestive Endoscopy Center of the Ninth People's Hospital(North),Shanghai Jiao Tong University School of Medicine,from January 1,2021 to June 1,2023 were retrospectively collected.Patients were divided into Hp-positive group and Hp-negative group based on histopathological biopsy or 13C breath test results.The endoscopic mucosal manifestations were recorded according to the Kyoto classification of gastritis,including atrophy,intestinal metaplasia,fold enlargement,diffuse redness,nodularity,RAC,red streak,and other 18 manifestations to verify the diagnostic value of Kyoto gastritis score for Hp infection.The mu-cosal manifestations with significant differences in univariate analysis were included in binary Logistic regression,and a modified prediction model was constructed according to the regression coefficients.ROC analysis was used to analyze the diagnostic value of Kyoto gastritis score and the modified prediction model for Hp infection.Results:The Hp infection rate was 54.47%.Intestinal metaplasia,fold enlargement,nodularity,diffuse redness,spotty redness,and sticky mucus were in-dependent predictors of Hp infection.RAC,red streak,white and flat elevated lesion were independent predictors of Hp non-infection.The area under the curve was 0.861(95%CI was 0.835～0.887),the accuracy was 75.2%,and the sensitivity and specificity were 88.5%and 65.1%.Mucosal manifestations such as spotty redness,sticky mucus,and RAC were incorpo-rated into the modified prediction model.The results showed that the specificity(85.9%),positive predictive value(88.2%),negative predictive value(85.4%)and AUC[0.929(95%CI was 0.910-0.947)]of the modified prediction model for Hp in-fection were higher than those of Kyoto gastritis score[65.1%,75.2%,82.5%and 0.861(95%CI was 0.835-0.887),respec-tively].Conclusions:Kyoto gastritis score has a certain application value for Hp in the Chinese population,and the modi-fied prediction model has a higher diagnostic value for Hp infection.关键词
幽门螺杆菌/黏膜表现/京都胃炎评分/预测模型Key words
Helicobacter pylori/mucosal manifestations/Kyoto gastritis score/prediction model分类
医药卫生
