Endoscopic finding of hematin represents strong gastric acidity.

Autor: Abe M; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Ueo T; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Takahashi H; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Akiyama H; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Togo K; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Fukuda M; Department of Gastroenterology (Makoto Abe, Tetsuya Ueo, Haruhiko Takahashi, Hidetoshi Akiyama, Kazumi Togo, Masahide Fukuda)., Kakisako Y; Department of Pathology, Oita Red Cross Hospital, Oita-shi (Yoko Kakisako)., Murakami K; Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu-shi (Kazunari Murakami), Oita, Japan.
Jazyk: angličtina
Zdroj: Annals of gastroenterology [Ann Gastroenterol] 2022 Jul-Aug; Vol. 35 (4), pp. 362-367. Date of Electronic Publication: 2022 Jun 02.
DOI: 10.20524/aog.2022.0720
Abstrakt: Background: Hematin is a state in which hemoglobin, as petechiae, is discolored to a brown coffee color by gastric hydrochloric acid. Given the nature of hematin, a close relationship between hematin and acidity has been suggested, but has not been confirmed. We investigated the clinical significance of endoscopic finding of hematin with respect to gastric acidity.
Methods: A total of 501 patients were assessed for both hematin and fasting gastric juice pH by endoscopy. Endpoints were as follows: 1) the relationship between the presence of hematin and the fasting gastric juice pH; and 2) the diagnostic performance of endoscopic hematin. In addition, we performed a supplementary in vitro study to clarify the relationship between hematin formation and various acid pH levels.
Results: The prevalence of hematin was 31.1% (142/206), 4.6% (5/109) and 45.2% (84/186) in the H. pylori -uninfected, -infected and -eradicated groups, respectively. The mean pH of fasting gastric juice in the hematin-positive cases was significantly lower than the hematin-negative cases (mean pH 1.2, 95% confidence interval [CI] 1.1-1.3 vs. 2.7 95%CI 2.5-3.0; P<0.001). The sensitivity, specificity, positive predictive value and negative predictive value of hematin for predicting strong acidic condition (pH 1 or 2 for fasting gastric juice) were 36.0%, 98.1%, 98.7% and 29.3%, respectively. Interobserver agreement was categorized as "excellent" (k=0.88). Supplementary in vitro results showed that hematin formation was only observed at a pH=1.
Conclusion: Endoscopic finding of hematin represent strong gastric acidity.
Competing Interests: Conflict of Interest: None
(Copyright: © Hellenic Society of Gastroenterology.)
Databáze: MEDLINE
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