Evaluating the efficacy of the Kyoto classification of gastritis in diagnosing Helicobacter pylori infection

Helicobacter pylori infection is a modifiable risk factor for gastric cancer, which is often diagnosed at late stages. The Kyoto classification of gastritis was developed to improve the accuracy of diagnosing H. pylori-associated gastritis and to assess precancerous changes in the gastric mucosa. Objective: to evaluate the efficacy of the Kyoto classification of gastritis in diagnosing active H. pylori infection. Material and methods. A retrospective case-control study involving 329 patients (206 women and 123 men) with a median age of 49 years (range 17—85 years) who underwent examination from 2020 to 2024. High-resolution white-light endoscopy and narrow-band imaging modes was used. H. pylori infection was diagnosed using histological examination and a rapid urease test. Statistical analysis included logistic regression and ROC analysis. Results. Statistically significant endoscopic features of infected mucosa included diffuse hyperemia (OR=255; 95% CI 91.3—937.3), enlarged folds (OR=10.7; 95% CI 3.190—35.906), granularity (OR=17.3; 95% CI 2.3—131.8), and mucosal edema (OR=15.1; 95% CI 8.663—26.445). Non-infected mucosa was characterized by regular arrangement of collecting venules (OR=0.018; 95% CI 0.006—0.060) and their recurrence (OR=0.074; 95% CI 0.035—0.156). The predictive model showed a sensitivity of 92.9% and specificity of 93.2%. Conclusion. The Kyoto classification of gastritis has proven to be a simple and effective tool for endoscopic diagnosis of H. pylori-associated gastritis. The study results offer new opportunities for clinical practice, facilitating early diagnosis and reducing gastric cancer incidence.