Diagnostic Accuracy of EndoFaster® and Narrow-Band Imaging Endoscopy in Patients with Impaired Gastric Acid Secretion: A Real-Time Prospective Study.
Journal
Gastroenterology research and practice
ISSN: 1687-6121
Titre abrégé: Gastroenterol Res Pract
Pays: Egypt
ID NLM: 101475557
Informations de publication
Date de publication:
2021
2021
Historique:
received:
22
12
2020
revised:
05
03
2021
accepted:
11
03
2021
entrez:
7
4
2021
pubmed:
8
4
2021
medline:
8
4
2021
Statut:
epublish
Résumé
EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis. To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies. Prospective study on consecutive adult patients undergoing gastroscopy between April and November 2018. Patients in therapy with proton pump inhibitors, previous gastric surgery, and/or known gastric neoplasia were excluded. At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster® in 15 seconds. Endoscopists were blinded to the report of EndoFaster®. Evaluation of gastric mucosa in HR-white light was firstly performed, then with HR-NBI allowing to perform targeted biopsies on areas suspected for intestinal metaplasia; otherwise, biopsies were performed according to the updated Sydney System protocol and sent for histopathological evaluation. Overall, 124 patients were included [64% F; 56 (18-85) years]. Corpus atrophic gastritis was present in 41.9% of patients. EndoFaster® showed an accuracy for corpus atrophic gastritis diagnosis, compared to histopathological evaluation as gold standard, of 87.1% and a sensitivity, specificity, PPV, and NPV of 78.8%, 93.1%, 89.1%, and 85.9%, respectively. pH showed a positive correlation with the severity score of atrophy ( EndoFaster® seems a promising tool to diagnose corpus atrophic gastritis. The evaluation of hypo-achlorhydria during gastroscopy can address bioptic sampling in corpus atrophic gastritis patients without intestinal metaplasia.
Sections du résumé
BACKGROUND
BACKGROUND
EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis.
AIMS
OBJECTIVE
To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies.
METHODS
METHODS
Prospective study on consecutive adult patients undergoing gastroscopy between April and November 2018. Patients in therapy with proton pump inhibitors, previous gastric surgery, and/or known gastric neoplasia were excluded. At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster® in 15 seconds. Endoscopists were blinded to the report of EndoFaster®. Evaluation of gastric mucosa in HR-white light was firstly performed, then with HR-NBI allowing to perform targeted biopsies on areas suspected for intestinal metaplasia; otherwise, biopsies were performed according to the updated Sydney System protocol and sent for histopathological evaluation.
RESULTS
RESULTS
Overall, 124 patients were included [64% F; 56 (18-85) years]. Corpus atrophic gastritis was present in 41.9% of patients. EndoFaster® showed an accuracy for corpus atrophic gastritis diagnosis, compared to histopathological evaluation as gold standard, of 87.1% and a sensitivity, specificity, PPV, and NPV of 78.8%, 93.1%, 89.1%, and 85.9%, respectively. pH showed a positive correlation with the severity score of atrophy (
CONCLUSION
CONCLUSIONS
EndoFaster® seems a promising tool to diagnose corpus atrophic gastritis. The evaluation of hypo-achlorhydria during gastroscopy can address bioptic sampling in corpus atrophic gastritis patients without intestinal metaplasia.
Identifiants
pubmed: 33824659
doi: 10.1155/2021/6616334
pmc: PMC8007348
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6616334Informations de copyright
Copyright © 2021 M. Cazzato et al.
Déclaration de conflit d'intérêts
Gianluca Esposito has received speaker fee from Niso Biomed.
Références
World J Gastroenterol. 2010 Nov 21;16(43):5496-501
pubmed: 21086570
Scand J Gastroenterol. 2015 Jul;50(7):856-65
pubmed: 25645880
J Med Screen. 2004;11(3):141-7
pubmed: 15333273
United European Gastroenterol J. 2016 Jun;4(3):339-42
pubmed: 27403299
BMJ Open. 2016 Nov 14;6(11):e012799
pubmed: 28137831
Aliment Pharmacol Ther. 2006 Jun;23 Suppl 2:2-8
pubmed: 16700898
Endoscopy. 2005 Oct;37(10):966-76
pubmed: 16189769
Aliment Pharmacol Ther. 2002 Jul;16(7):1249-59
pubmed: 12144574
GE Port J Gastroenterol. 2018 Dec;26(1):40-53
pubmed: 30675503
Gastrointest Endosc. 2017 Nov;86(5):857-865
pubmed: 28366441
Gut Liver. 2018 Mar 15;12(2):158-164
pubmed: 28918609
Endoscopy. 2016 Aug;48(8):723-30
pubmed: 27280384
Acta Physiol (Oxf). 2014 Feb;210(2):239-56
pubmed: 24279703
Helicobacter. 2014 Dec;19(6):417-24
pubmed: 25231208
Nat Rev Gastroenterol Hepatol. 2013 Sep;10(9):529-41
pubmed: 23774773
Dig Liver Dis. 2019 Dec;51(12):1621-1632
pubmed: 31635944
CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
pubmed: 21296855
Gastroenterology. 1997 Jul;113(1):15-24
pubmed: 9207257
Endoscopy. 2019 Jun;51(6):515-521
pubmed: 30577062
Eur J Gastroenterol Hepatol. 2018 Nov;30(11):1291-1296
pubmed: 30161028
Endoscopy. 2019 Apr;51(4):365-388
pubmed: 30841008
Dig Liver Dis. 2014 Aug;46(8):759-60
pubmed: 24721104
Aliment Pharmacol Ther. 2001 Nov;15(11):1753-61
pubmed: 11683689
Aliment Pharmacol Ther. 2017 Oct;46(7):657-667
pubmed: 28782119
Am J Surg Pathol. 1996 Oct;20(10):1161-81
pubmed: 8827022
Gastrointest Endosc. 2007 Nov;66(5):881-90
pubmed: 17963873