Dataset Information

Standard vs magnifying narrow-band imaging endoscopy for diagnosis of Helicobacter pylori infection and gastric precancerous conditions.

ABSTRACT:

Background

Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer. However, there are no comparative data on the utility of standard and magnifying narrow-band imaging (M-NBI) endoscopy for diagnosing Helicobacter pylori (H. pylori) infection, gastric atrophy, and intestinal metaplasia.

Aim

To compare the diagnostic performance of standard and M-NBI endoscopy for H. pylori gastritis and precancerous conditions.

Methods

In 254 patients, standard endoscopy findings were classified into mosaic-like appearance (type A), diffuse homogenous redness (type B), and irregular redness with groove (type C). Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci (type Z-1), more dilated and linear pits without sulci (type Z-2), and loss of gastric pits with coiled vessels (type Z-3).

Results

The diagnostic accuracy of standard and M-NBI endoscopy for H. pylori gastritis was 93.3% and 96.1%, respectively. Regarding gastric precancerous conditions, the accuracy of standard and M-NBI endoscopy was 72.0% vs 72.6% for moderate to severe atrophy, and 61.7% vs. 61.1% for intestinal metaplasia in the corpus, respectively. Compared to type A and Z-1, types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy [odds ratio (OR) = 5.56 and 8.67] and serum pepsinogen I/II ratio of ≤ 3 (OR = 4.48 and 5.69).

Conclusion

Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H. pylori gastritis and precancerous conditions.

SUBMITTER: Cho JH

PROVIDER: S-EPMC8117737 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundDiagnosis of Helicobacter pylori (H. pylori) infection using magnifying endoscopy offers advantages over conventional invasive and noninvasive tests.ObjectiveThis meta-analysis aimed to assess the diagnostic performance of magnifying endoscopy in the prediction of H. pylori infection.MethodsA literature search of the PubMed, Medline, EMBASE, Science Direct and the Cochrane Library databases was performed. A random-effects model was used to calculate the diagnostic efficiency of magnifying endoscopy for H. pylori infection. A summary receiver operator characteristic curve was plotted, and the area under the curve (AUC) was calculated.ResultsA total of 18 studies involving 1897 patients were included. The pooled sensitivity and specificity of magnifying endoscopy to predict H. pylori infection were 0.89 [95% confidence interval (CI) 0.87-0.91] and 0.82 (95%CI 0.79-0.85), respectively, with an AUC of 0.9461. When targeting the gastric antrum, the pooled sensitivity and specificity were 0.82 (95%CI 0.78-0.86) and 0.72 (95%CI 0.66-0.78), respectively. When targeting the gastric corpus, the pooled sensitivity and specificity were 0.92 (95%CI 0.90-0.94) and 0.86 (95%CI 0.82-0.88), respectively. The pooled sensitivity and specificity using magnifying white light endoscopy were 0.90 (95%CI 0.87-0.91) and 0.81 (95%CI 0.77-0.84), respectively. The pooled sensitivity and specificity using magnifying chromoendoscopy were 0.87 (95%CI 0.83-0.91) and 0.85 (95%CI 0.80-0.88), respectively. The "pit plus vascular pattern" classification in the gastric corpus observed by magnifying endoscopy was able to accurately predict the status of H. pylori infection, as indicated by a pooled sensitivity and specificity of 0.96 (95%CI 0.94-0.97) and 0.91 (95%CI 0.87-0.93), respectively, with an AUC of 0.9872.ConclusionsMagnifying endoscopy was able to accurately predict the status of H. pylori infection, either in magnifying white light endoscopy or magnifying chromoendoscopy mode. The "pit plus vascular pattern" classification in the gastric corpus is an optimum diagnostic criterion.