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.

The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

“…As a result, 34 articles were ultimately included in the meta-analysis. 10 , 11 , 13 , 14 , 20 , 24 - 52 Fig. 1 shows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart of this process.…”

Helicobacter pylori eradication: Exploring its impacts on the gastric mucosa

“…The high risk of GC emphasizes the need for early detection and proper treatment of H. pylori infection. Along with standard endoscopy, new endoscopic techniques, such as magnifying endoscopy[ 133 ], endocytoscopy[ 134 , 135 ], magnifying narrow-band imaging (M-NBI)[ 136 ], I-Scan[ 137 ], endomicroscopy[ 138 ], and LCI[ 139 - 141 ], can be used to detect H. pylori infection. Magnifying endoscopy allows the structure of the mucosa and the subepithelial capillary network around the gastric fovea to be observed in detail.…”

“…Moreover, the NBI system and I-Scan are also the recent developments in computed virtual chromoendoscopy imaging[ 137 ]. The diagnostic accuracy of M-NBI endoscopy for gastritis and magnifying I-Scan for H. pylori infection was 96.1% and 94.0%, respectively[ 136 , 137 ]. Currently, a novel imaging mode under blue laser endoscopy, LCI, plays an important role in endoscopic diagnosis of active H. pylori infection or distal gastric disease, through its enhanced slight differences in mucosal color[ 139 - 141 ].…”

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

“…In Western countries, RAC and endoscopic IM have been extensively studied; however, other endoscopic findings, such as atrophy, EF, nodularity, DR, and MLR, have been less extensively explored, and further studies in more varied populations are required. This article does not mention a variety of important endoscopic findings, including spotty redness as a predictor of H. pylori infection[ 62 ]; xanthoma[ 57 , 63 , 64 ], foveolar hyperplastic polyp[ 65 ], refluxed bile[ 66 ], and a lack of fundic gland polyp[ 64 ] to predict GC; and depressive erosion and fundic gland polyp as indicators of functional dyspepsia[ 32 , 67 ]. Further research is required to confirm these findings.…”