Regular arrangement of collecting venules under endoscopy for predicting a Helicobacter pylori-negative stomach: A systematic review and meta-analysis

Li, Lunan; Jing, Jiyong; Gao, Huiqin; Zhang, Chenjing; Lou, Haifang; Pan, Wensheng

doi:10.1016/j.gastrohep.2020.08.003

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…In our study, RAC presence has only 51.4% sensitivity and 71.0% NPV for predicting H. pylori -negative status in routine clinical practice despite a good specificity (96.7%) and PPV (92.7%). These studies strongly supported the idea that the presence of RAC in the lesser corpus can accurately identify H. pylori -negative gastric body mucosa [ 24 ], but RAC absence did not always point out H. pylori -positive corpus mucosa.…”

Section: Discussionsupporting

confidence: 67%

Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy

Yuan

Lin

et al. 2021

BMC Gastroenterol

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Background The sensitivity of regular arrangement of collecting venules (RAC)-positive pattern for predicting Helicobacter pylori (H. pylori)-negative status greatly altered from 93.8 to 48.0% in recent two decades of various studies, while the reason behind it remained obscure. The aim of this study was to investigate the value of RAC as an endoscopic feature for judging H. pylori status in routine endoscopy and reviewed the underlying mechanism. Methods A prospective study with high-definition non-magnifying endoscopy was performed. RAC-positive and RAC-negative patients were classified according to the collecting venules morphology of the lesser curvature in gastric corpus. Gastric biopsy specimens were obtained from the lesser and greater curvature of corpus with normal RAC-positive or abnormal RAC-negative mucosal patterns. Helicobacter pylori status was established by hematoxylin and eosin staining and immunohistochemistry. Results 41 RAC-positive and 124 RAC-negative patients were enrolled from June 2020 to September 2020. The prevalence of H. pylori infection in patients with RAC-positive pattern and RAC-negative pattern was 7.3% (3/41) and 71.0% (88/124), respectively. Among all 124 RAC-negative patients, 36 (29.0%) patients were H. pylori-negative status. Ten patients (32.3%) demonstrated RAC-positive pattern in 31 H. pylori-eradicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of RAC-positive pattern for predicting H. pylori-negative status were 51.4% (95% CI, 0.395–0.630), 96.7% (95% CI, 0.900–0.991), 92.7% (95% CI, 0.790–0.981), and 71.0% (95% CI, 0.620–0.786), respectively. Conclusions RAC presence can accurately rule out H. pylori infection of gastric corpus, and H. pylori-positive status cannot be predicted only by RAC absence in routine endoscopy. Trial registration The present study is a non-interventional trial.

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Section: Discussionsupporting

confidence: 67%

Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy

Yuan

Lin

et al. 2021

BMC Gastroenterol

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“…In our study, RAC presence has only 51.4% sensitivity and 71.0% NPV for predicting H. pylori-negative status in routine clinical practice despite a good speci city (96.7%) and PPV (92.7%). These studies strongly supported the idea that the presence of RAC in the lesser corpus can accurately identify H. pylori-negative gastric body mucosa [24], but RAC absence did not always point out H. pylori-positive corpus mucosa.…”

Section: Discussionsupporting

confidence: 59%

Association Between Regular Arrangement of Collecting Venules and Helicobacter Pylori Status in Routine Endoscopy

Yuan

Lin

et al. 2021

Preprint

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Background: The sensitivity of regular arrangement of collecting venules (RAC)-positive pattern for predicting Helicobacter pylori (H. pylori)-negative status greatly altered from 93.8% to 48.0% in recent two decades of various studies, while the reason behind it remained obscure. The aim of this study was to investigate the value of RAC as an endoscopic feature for judging H. pylori status in routine endoscopy and reviewed the underlying mechanism.Methods: A prospective study with high-definition non-magnifying endoscopy was performed. RAC-positive and RAC-negative patients were classified according to the collecting venules morphology of the lesser curvature in gastric corpus. Gastric biopsy specimens were obtained from the lesser and greater curvature of corpus with normal RAC-positive or abnormal RAC-negative mucosal patterns. H. pylori status was established by hematoxylin and eosin staining and immunohistochemistry. Results: 41 RAC-positive and 124 RAC-negative patients were enrolled from June 2020 to September 2020. The prevalence of H. pylori infection in patients with RAC-positive pattern and RAC-negative pattern was 7.3% (3/41) and 71.0% (88/124), respectively. Among all 124 RAC-negative patients, 36 (29.0%) patients were H. pylori-negative status. Ten patients (32.3%) demonstrated RAC-positive pattern in 31 H. pylori-eradicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of RAC-positive pattern for predicting H. pylori negative status were 51.4% (95%CI, 0.395-0.630), 96.7% (95%CI, 0.900-0.991), 92.7% (95%CI, 0.790-0.981), and 71.0% (95%CI, 0.620-0.786), respectively.Conclusions: RAC presence can accurately rule out H. pylori infection of gastric corpus, and H. pylori-positive status cannot be predicted only by RAC absence in routine endoscopy.Trial registrationThe present study is a non-interventional trial.

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“…30 In a meta-analysis from 2020 including studies published between 2002 and 2019, Li and colleagues concluded that RAC is a valuable endoscopic finding for predicting patients without H. pylori infection. 42 However, this meta-analysis has substantial shortcomings in its quantitative data analysis for heterogeneity, with a reported I 2 of 0 (95% CI: 0%-100%). In contrast, our study found significant heterogeneity between studies, with an I 2 of 99.95%…”

Section: Discussionmentioning

confidence: 99%

Regular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta‐analysis

et al. 2021

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Helicobacter pylori (H. pylori) is a gram-negative bacterium with an overall global prevalence of 44.3%, ranging from 50.8% in developing countries to 34.7% in developed countries. 1 H. pylori has been categorised as a class I carcinogen for gastric cancer in 1994 and is the most common cause of gastric cancer. [2][3][4][5] It is estimated that H. pylori infection contributes to 89% of non-cardiac gastric cancers, which accounts for 78% of gastric cancer cases. 6,7 Studies have consistently shown that eradication of chronic H. pylori infection significantly reduces gastric cancer risk. 5,7,8,9,10 Graham et al conducted a meta-analysis including 48,064 individuals with a total follow-up of 340,255 person-years, demonstrating that gastric cancer risk reduces by about 50% after the eradication of H. pylori. 7 A similar finding that the eradication of H. pylori was associated with an odds ratio of 0.46 for gastric cancer risk has also been verified in an updated metaanalysis. 11 Therefore, the strong association between H. pylori and gastric cancer risk highlights the importance of adequate detection and eradication of H. pylori in clinical practice.Conventional examinations for the diagnosis of H. pylori infection include non-invasive tests such as urea breath tests, faecal antigen tests, and serological parameters, and invasive tests such as

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Regular arrangement of collecting venules under endoscopy for predicting a Helicobacter pylori-negative stomach: A systematic review and meta-analysis

Cited by 8 publications

References 20 publications

Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy

Association between regular arrangement of collecting venules and Helicobacter pylori status in routine endoscopy

Association Between Regular Arrangement of Collecting Venules and Helicobacter Pylori Status in Routine Endoscopy

Regular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta‐analysis

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