Assessment ofHelicobacter pyloristatus by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Abstract

ObjectivesHelicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing area of research, as are their diagnostic accuracies. This study aimed to establish the diagnostic accuracy of several mucosal features predictive of H. pylori negative status and formulate a simple prediction model for use at the time of endoscopy.DesignPatients undergoing high-definition upper gastrointestinal (GI) endoscopy without magnification were recruited prospectively. During the endoscopy, the presence or absence of specific endoscopic findings was noted. Sydney protocol biopsies were used as the diagnostic reference standard, and urease test if taken. The results informed a logistic regression model used to produce a simple diagnostic approach. This model was subsequently validated using a further cohort of 30 patients.Results153 patients were recruited and completed the study protocol. The prevalence of active H. pylori infection was 18.3% (28/153). The overall diagnostic accuracy of the simple prediction model was 80.0%, and 100% of patients with active H. pylori infection were correctly classified. The presence of regular arrangement of collecting venules (RAC) showed a positive predictive value for H. pylori naïve status of 90.7%, rising to 93.6% for patients under the age of 60.ConclusionA simple endoscopic model may be accurate for predicting H. pylori status of a patient, and the need for biopsy-based tests. The presence of RAC in the stomach is an accurate predictor of H. pylori negative status, particularly in patients under the age of 60.Trial registration numberThe study was registered with ClinicalTrials.gov, No. NCT02385045.

Upper Endoscopy Biopsy Versus Helicobacter Pylori Antigen in Stool Test in Evaluation of Helicobacter Pylori Infection

“…In the present study, there was female predominance (56.4%), which near to the results in the study done by Glover et al (16) who found that (56.9%) of their studied cases were females. But in the study was done by Osman et al (17) there were 36 (61%) males and (39%) females.…”

“…In the current study, The most frequent presentations findings among the studied cases pre therapy was dyspepsia (63.6%) followed by epigastric pain (23.6%), abdominal fullness presented in 12.7% and vomiting (18%) and persistence of the symptoms dyspepsia in 27.3%, abdominal fullness in 10.9% while decrease abdominal pain to 3.6% and vomiting 1.8% which was not following Glover et al (16) who found that Chronic gastritis was the most common endoscopic findings in pre and posttreatment of their studied cases, also in the study was prepared by Calik et al (14) via endoscopic biopsy, 86.8 percent were diagnosed with gastritis, and 13.1 percent were diagnosed with ulcer. Hussein et al (19) discovered that 46.1% had antral gastritis, 24.3% had dyspepsia, and 16.5% had both stomach and duodenal ulcers.…”

Consistency between the endoscopic Kyoto classification and pathological updated Sydney system for gastritis: A cross‐sectional study

“…This study only investigated endoscopic findings that were used in the Kyoto classification score. Further analysis is expected, including other findings related to gastric cancer, such as xanthoma, 38 foveolar hyperplastic polyp, 39 RAC, 40 and fundic gland polyp. 41 Although this study excluded patients who received prior H. pylori eradication therapy, it was found that the H. pylori ‐negative group included H. pylori ‐naïve patients, patients with H. pylori that spontaneously disappeared, and patients who received unintentional H. pylori eradication by antibiotic treatment for other infectious diseases.…”

Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis

“…Evidence of RAC as an indicator of non-infection has been reported in both in Japan[ 17 , 18 ] and several other countries[ 19 - 21 ], including in the west[ 22 - 24 ], as shown in Table 2 . Two recent meta-analyses reported that the sensitivity and specificity of RAC for predicting non-infection were 78%-80% and 94%-97%, respectively[ 25 , 26 ].…”