Gastric Morphology During Gastroscopy Associated with <i>Helicobacter pylori</i> Infection

As a Gram-negative, microaerophilic bacterium, <i>Helicobacter pylori</i> (<i>H. pylori</i>) colonizes and thrives in the gastric mucosa. To enable early detection and treatment of <i>H. pylori</i> infection through exploring the clinical value of white light gastroscope endoscopic features in diagnosing <i>H. pylori</i>. A retrospective analysis was conducted on 968 patients who underwent routine gastroscopy over a 2-year period (March 1st, 2021-March 1st, 2023). A significant association was observed between <i>H. pylori</i> infection and age (<i>p</i> < 0.001), family history of <i>H. pylori</i> infection (<i>p</i> < 0.001), and gastric symptoms (<i>p</i> < 0.001). White light gastroscope findings demonstrated that diffuse erythema (<i>p</i> < 0.001), spotted redness (<i>p</i> < 0.001), mucosal swelling (<i>p</i> < 0.001), elongated and enlarged folds (<i>p</i> < 0.001), digestive tract ulcers (<i>p</i> < 0.001), proliferative polyps (<i>p</i> = 0.018), and erosions with depression (<i>p</i> < 0.001) were more frequent in <i>H. pylori</i>-infected individuals. Conversely, old bleeding spots (<i>p</i> = 0.003), gastric fundic glandular polyps (<i>p</i> = 0.048), and regular arrangement of collecting venules (RAC) (<i>p</i> < 0.001) were less common in <i>H. pylori</i>-infected patients. Diffuse erythema (odds ratio [OR] = 3.84, <i>p</i> = 0.002), spotted redness (OR = 2.63, <i>p</i> = 0.008), mucosal swelling (OR = 1.97, <i>p</i> = 0.007), elongated and enlarged folds (OR = 2.15, <i>p</i> = 0.015), digestive tract ulcers (OR = 1.49, <i>p</i> = 0.036), and erosions with depression (OR = 1.86, <i>p</i> = 0.022) were identified as independent risk factors for <i>H. pylori</i> infection, while the RAC served as a protective factor.