Document Detail


Comparison of high resolution magnifying endoscopy and standard videoendoscopy for the diagnosis of Helicobacter pylori gastritis in routine clinical practice: a prospective study.
MedLine Citation:
PMID:  19191891     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It has been shown that standard endoscopic features often labeled as gastritis has a poor correlation with histopathology. Recently, high resolution magnifying endoscopy has been reported to be an effective method to diagnose gastritis. The aim of the present study was to compare standard endoscopy with magnifying endoscopy for the diagnosis of Helicobacter pylori gastritis, and to determine whether gastritis can be diagnosed based on findings at magnification endoscopy. MATERIALS AND METHODS: A total of 129 patients were enrolled into the study. Erythema, erosions, prominent area gastrica, nodularity, and regular arrangement of collecting venules (RAC) were investigated by standard endoscopy. Standard endoscopy was followed by magnifying endoscopy in all patients, and repeated in 55 patients after indigo carmine spraying. RESULTS: None of the standard endoscopic features showed a sensitivity of more than 70% for H. pylori gastritis, except RAC pattern analysis. Absence of a corporal RAC pattern had 85.7% sensitivity and 82.8% specificity for predicting H. pylori infection. Under magnification, the sensitivity and specificity of regular corporal pattern (regular collecting and capillary vascular structures with gastric pits resembling pinholes) for predicting normal histology were 90.3% and 93.9%, respectively. Loss of collecting venules, or both collecting and capillary structures was correlated with chronic inflammation and activity. With the progression of mucosal atrophy, irregular collecting venules became visible. The values for irregularly arranged antral ridge pattern for the prediction of antral gastritis were 89.3% and 65.2%, respectively. Indigo carmine staining increased sensitivity and specificity up to 97.6% and 100% for corporal gastritis, and up to 88.4% and 75.0% for antral gastritis, respectively. Indigo carmine staining significantly increases the detection of intestinal metaplasia. CONCLUSIONS: High resolution magnifying is superior to standard endoscopy for the diagnosis of H. pylori gastritis, and identification of specific histopathologic features such as atrophy and intestinal metaplasia seems possible.
Authors:
Can Gonen; Ilkay Simsek; Sulen Sarioglu; Hale Akpinar
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Helicobacter     Volume:  14     ISSN:  1523-5378     ISO Abbreviation:  Helicobacter     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-04     Completed Date:  2009-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9605411     Medline TA:  Helicobacter     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-21     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, School of Medicine, Dokuz Eylul University, Izmir, Turkey. drcgnn@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Endoscopy, Digestive System / methods*
Female
Gastritis / diagnosis*,  microbiology
Helicobacter Infections / diagnosis*,  microbiology
Helicobacter pylori / isolation & purification
Humans
Male
Middle Aged
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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