{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T22:04:45Z","timestamp":1785017085757,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The characteristic endoscopic findings of non\u2010<jats:italic>Helicobacter pylori Helicobacter<\/jats:italic> (NHPH) gastritis, including white marbled appearance and crack\u2010like mucosa, have been reported. However, these findings can also manifest in <jats:italic>H. pylori<\/jats:italic> (HP)\u2010infected gastritis. This study compared NHPH gastritis and mild atrophic HP gastritis to identify features that may enhance NHPH diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A total of 2087 patients underwent upper gastrointestinal endoscopy and were histologically evaluated by multiple gastric mucosal biopsies according to the updated Sydney System (USS) at Shinshu University Hospital between 2005 and 2023. Among them, nine patients were classified into the NHPH group and 134 patients with HP infection and mild atrophy were classified into the HP group for retrospective comparisons of endoscopic findings and clinicopathological characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All nine patients in the NHPH group (eight males [89%], median\u2009\u00b1\u2009standard deviation [SD] age: 49\u2009\u00b1\u200913.0\u2009years) were infected with <jats:italic>H. suis<\/jats:italic>. The 134 patients in the HP group contained 70 men (52%) and had a median\u2009\u00b1\u2009SD age of 35\u2009\u00b1\u200919.9\u2009years. Endoscopic findings were statistically comparable for white marbled appearance (three patients [33%] in the NHPH group and 37 patients [31%] in the HP group) and crack\u2010like mucosa (three patients [33%] and 27 patients [20%], respectively). Diffuse redness was significantly less frequent in the NHPH group (one patient [14%] vs. 97 patients [72%], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). White marbled appearance or crack\u2010like mucosa without diffuse redness was significantly more common in the NHPH group (56% vs. 13%, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), with a sensitivity and specificity of 56% and 87%, respectively. Mean USS neutrophil infiltration and <jats:italic>Helicobacter<\/jats:italic> density scores were significantly higher in the HP group (both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), which might have influenced the endoscopic findings of diffuse redness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When endoscopic findings of white marbled appearance or cracked\u2010like mucosa are present, evaluation for diffuse redness may contribute to a more accurate diagnosis of NHPH gastritis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13070","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T04:49:20Z","timestamp":1711082960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnosis by combination of endoscopic findings helps differentiate non\u2010<i>Helicobacter pylori Helicobacter<\/i>\u2010infected gastritis from <i>Helicobacter pylori<\/i>\u2010infected gastritis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6838-4931","authenticated-orcid":false,"given":"Takuma","family":"Okamura","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2269-0132","authenticated-orcid":false,"given":"Yugo","family":"Iwaya","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadanobu","family":"Nagaya","sequence":"additional","affiliation":[{"name":"Endoscopic Examination Center Shinshu University Hospital  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Shinshu University Hospital  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Negishi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Shinshu University Hospital  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Biomedical Laboratory Sciences, School of Health Sciences Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeji","family":"Umemura","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine  Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)92754-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70167-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-08962-y"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.2005.01844.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12811"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12700"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.55.5891"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000431169"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1098086"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199610000-00001"},{"key":"e_1_2_9_12_1","volume-title":"Kyoto Classification of Gastritis","author":"Kato M","year":"2018"},{"key":"e_1_2_9_13_1","first-page":"43","article-title":"Characteristics of X\u2010ray and endoscopic findings in NHPH\u2010infected gastritis","volume":"58","author":"Tsukadaira T","year":"2023","journal-title":"Stomach and Intestine"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12031"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2015.05.008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12845"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12887"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.13070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T07:21:55Z","timestamp":1718781715000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.13070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/hel.13070"],"URL":"https:\/\/doi.org\/10.1111\/hel.13070","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"value":"1083-4389","type":"print"},{"value":"1523-5378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]},"assertion":[{"value":"2023-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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