{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T07:13:59Z","timestamp":1758438839562,"version":"3.44.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Map-like redness is a known gastric mucosal finding observed after Helicobacter pylori eradication. Recently, we identified gastric lesions resembling barnacles and observed that they appear more commonly in cases of post-H. pylori infection. This study aimed to investigate clinicopathological characteristics of these barnacle-like lesions.<\/jats:p><jats:p>We analyzed clinical characteristics in 436 consecutive patients examined at Kawasaki Medical School General Medical Center. Histopathological examination was conducted in 43 patients, with 65 biopsies taken from barnacle-like lesions and 17 from the surrounding mucosa. The 43 patients comprised 20 patients biopsied at General Medical Center and 23 patients at Junpukai.<\/jats:p><jats:p>In total, 413 patients (208 women) were included in the analysis after excluding 23 patients based on exclusion criteria. Barnacle-like lesions were identified in 66 patients (16.0%), most frequently around the gastric angle, and were significantly more common in patients with mild atrophy of the fundic mucosa. Of the 66 patients with barnacle-like lesions, 65 were considered to have a post-H. pylori infection status and one was currently infected. Histopathological examination revealed intestinal metaplasia in 54 (83.1%) of the 65 biopsies from barnacle-like lesions. By contrast, all 17 biopsies from surrounding mucosa showed normal fundic mucosa without inflammation or atrophy.<\/jats:p><jats:p>Barnacle-like lesions are a characteristic endoscopic finding of gastric mucosa post-infected with H. pylori and are histopathologically consistent with intestinal metaplasia.<\/jats:p>","DOI":"10.1055\/a-2645-7506","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T19:32:52Z","timestamp":1751311972000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Barnacle-like lesions in the gastric mucosa: Clinicopathological study of a novel endoscopic finding"],"prefix":"10.1055","volume":"13","author":[{"given":"Aya","family":"Sunago","sequence":"additional","affiliation":[{"name":"Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Murao","sequence":"additional","affiliation":[{"name":"Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Haruma","sequence":"additional","affiliation":[{"name":"General Internal Medicine 2, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Ayaki","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, HITO Medical Center, Shikokuchuou, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Manabe","sequence":"additional","affiliation":[{"name":"Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Fujita","sequence":"additional","affiliation":[{"name":"Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiko","family":"Suehiro","sequence":"additional","affiliation":[{"name":"General Internal Medicine 2, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"General Internal Medicine 2, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Inoue","sequence":"additional","affiliation":[{"name":"Health Care Medicine, Junpukai Health Maintenance Center, Okayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiro","family":"Mabe","sequence":"additional","affiliation":[{"name":"Gastroenterology, Mabe Goryokaku Gastrointestinal Endoscopy Clinic, Hakodate, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichiro","family":"Kanda","sequence":"additional","affiliation":[{"name":"Health Care Medicine, Kawasaki Medical School, Kawasaki Medical School, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoari","family":"Kamada","sequence":"additional","affiliation":[{"name":"Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, 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Wagner","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"ref4","first-page":"959","article-title":"Helicobacter pylori infection is the major risk factor for atrophic gastritis","volume":"91","author":"H Kawaguchi","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/j.1572-0241.1998.00408.x","article-title":"Helicobacter pylori infection and gastric neoplasia: correlations with histological gastritis and tumor histology","volume":"93","author":"K Komoto","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1007\/s00535-017-1407-1","article-title":"World trends for H. pylori eradication therapy and gastric cancer prevention strategy by H. pylori test-and-treat","volume":"53","author":"H Suzuki","year":"2018","journal-title":"J Gastroenterol"},{"volume-title":"Kyoto classification of gastritis. 1st ed","year":"2017","author":"K Haruma","key":"ref7"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/den.13486","article-title":"Validity of endoscopic features for the diagnosis of Helicobacter pylori infection status based on the Kyoto classification of gastritis","volume":"32","author":"S Yoshii","year":"2010","journal-title":"Dig Endosc"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/den.12581","article-title":"Endoscopic features associated with development of metachronous gastric cancer in patients who underwent endoscopic resection followed by Helicobacter pylori eradication","volume":"28","author":"K Moribata","year":"2016","journal-title":"Dig Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.gie.2019.06.043","article-title":"Linked color imaging identifies important risk factors associated with gastric cancer after successful eradication of Helicobacter pylori","volume":"90","author":"A 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