Review: Diagnosis of Helicobacter pylori infection

Abstract

New endoscopic techniques, especially linked colour imaging (LCI) and blue laser imaging (BLI), were extensively evaluated this year either for the diagnosis of Helicobacter pylori gastritis or the detection of early gastric cancer (EGC). In the first case, the studies followed a similar protocol. Endoscopy was performed with the new imaging technique as well as white light imaging (WLI) on a group of patients for whom the H pylori status was established by various methods. Several images were obtained from different parts of the stomach and submitted blindly to a group of endoscopists (at least 4) for evaluation. The first aim was to determine the sensitivity and specificity of the new method vs WLI. LCI always performed better than WLI with sensitivity and specificity for LCI ranging from 83.8% to 85.4% and 79.5% to 99.5%, respectively (Table 1). The difficulty stemmed from the fact that there are different stages of H pylori gastritis, from active inflammation to atrophy and intestinal metaplasia, which exhibit very different aspects. Nevertheless in their study, Wang et al concluded that identification of H pylori gastritis by LCI was especially reliable in the corpus. 1 In another study by Jiang et al, using a score of 3.5 as the cutoff value, sensitivity and specificity were 83.8% and 99.5%, respectively, for the diagnosis of H pylori gastritis among 358 patients. 2 Ono et al 3

What Is New in Helicobacter pylori Diagnosis. An Overview

“…The urease test is rapid (RUT), easy to perform, highly specific, and inexpensive for H. pylori diagnosis. However, RUT requires a high density of bacteria, for example, in the standard commercial kits, at least a 10 4 bacterial load in the gastric specimens is required [ 41 ]. False-negative results may occur with recent use of antibiotics, bismuth-containing compounds, PPIs, especially omeprazole and lansoprazole, and in children younger than five years [ 42 ].…”

“…More importantly, the concomitant PPI-use did not influence test accuracy [ 46 ]. In addition to false negative, false-positive RUT may also occur in the presence of urease positive bacteria [ 41 ]. The gastric samples used for RUT can be re-used for molecular testing in order to identify bacterial resistance.…”

Helicobacter pylori Outer Membrane Vesicles and Extracellular Vesicles from Helicobacter pylori-Infected Cells in Gastric Disease Development

“…Among the techniques for processing gastric biopsies, PCR appears to be a more sensitive method compared to the others [ 182 ]. Progress has been made in obtaining endoscopic images through the development of linked color imaging (LCI) and blue laser imaging (BLI), whereby sensitivity and specificity are on the order of 83.8–85.4% and 79.5–99.5%, respectively [ 183 ]. In addition, artificial intelligence has been used to analyze the presence of H. pylori in images obtained by LCI [ 184 ].…”

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

“…Helicobacter pylori (H. pylori) infection has been involved in over 60% of people in the world [1], which is a well-known risk factor for gastric disorders including active gastritis, peptic ulcer, MALT lymphoma and adenocarcinoma [2]. Invasive and noninvasive diagnostic tests for H. pylori have been extensively used in the clinical practice [3][4][5]. Among these methods, endoscopic approach is a potential bene t, which can provide real-time mucosal ndings and prompt targeted biopsy.…”