Gastric juice analysis in clinical practice: why, how, and when. The experience with EndoFaster.


Journal

European journal of gastroenterology & hepatology
ISSN: 1473-5687
Titre abrégé: Eur J Gastroenterol Hepatol
Pays: England
ID NLM: 9000874

Informations de publication

Date de publication:
27 Dec 2023
Historique:
medline: 5 1 2024
pubmed: 5 1 2024
entrez: 5 1 2024
Statut: aheadofprint

Résumé

Gastric juice analysis may be useful for clinical purposes, including the detection of H. pylori infection and diffuse atrophic gastritis on gastric mucosa. EndoFaster is a novel device which performs real-time analysis of gastric juice revealing the infection and hypochlorhydria by measuring ammonium concentrations and pH levels. This review aimed to evaluate the clinical applications of such a tool. By considering data from overall 11 studies, the values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, positive likelihood ratio, and negative likelihood ratio were 90%, 86%, 67%, 96%, 87%, 8.5, and 0.13, respectively, for H. pylori diagnosis, and 83%, 92%, 58%, 97%, 91%, 9.9 and 0.2, respectively, for suspecting diffuse atrophic gastritis. The very high value of negative predictive values for both H. pylori and mucosal atrophy would allow avoiding to perform useless negative gastric biopsies when the results of the test are negative. Some promising data suggest that gastric juice analysis may be useful also to diagnose H. pylori infection in patients with chronic active gastritis without evidence of bacteria at histology, as well as in predicting persistent acid reflux in patients on proton pump inhibitor therapy for reflux disease.

Identifiants

pubmed: 38179876
doi: 10.1097/MEG.0000000000002704
pii: 00042737-990000000-00284
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Références

Goldschmiedt M, Feldam M. Gastric secretion in health and disease. In Sleisenger Fordtran editors. Gastrointestinal Disease. 5th edition 1993; pp. 524–544.
Martinsen TC, Fossmark R, Waldum HL. The phylogeny and biological function of gastric juice Microbiological consequences of removing gastric acid. Int J Mol Sci 2019; 20:6031.
Ghosh T, Lewis DI, Axon ATR, Everett M. Review article: methods of measuring gastric acid secretion. Aliment Pharmacol Ther 2011; 33:768–781.
Phan J, Benhammou JN, Pisegna JR. Gastric hypersecretory states: investigation and management. Curr Treat Options Gastroenterol 2015; 13:386–397.
Weinstein DH, deRijke S, Chow CC, Foruraghi L, Zhao X, Wright EC, et al. A new method for determining gastric acid output using a wireless pH sensing capsule. Aliment Pharmacol Ther 2013; 37:1198–1209.
Alakkari A, Zullo A, O’Connor HJ. Helicobacter pylori and nonmalignant diseases. Helicobacter 2011; 16(Suppl 1):33–37.
Sbrozzi-Vanni A, Zullo A, Di Giulio E, Hassan C, Corleto VD, Lahner E, et al. Low prevalence of idiopathic peptic ulcer disease: an Italian endoscopic survey. Dig Liver Dis 2010; 42:773–776.
Zullo A, Esposito G, Ridola L, Hassan C, Lahner E, Perri R, et al.; on behalf of AIGO-SIED study group. Prevalence of lesions detected at upper endoscopy: An Italian survey. Eur J Int Med 2014; 25:772–776.
Scarpignato C, Gatta L, Zullo A, Blandizzi C; SIF-AIGO-FIMMG Group. SIF-AIGO-FIMMG Group Effective and safe proton pump inhibitor therapy in acid-related diseases - a position paper addressing benefits and potential harms of acid suppression. BMC Med 2016; 14:179.
Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis 2008; 40:650–658.
Annibale B, Esposito G, Lahner E. A current clinical overview of atrophic gastritis. Expert Rev Gastroenterol Hepatol 2020; 14:93–102.
Lahner E, Zagari RM, Zullo A, Di Sabatino A, Meggio A, Cesaro P, et al. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management a position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists (AIGO), the Italian Society of Digestive Endoscopy (SIED), the Italian Society of Gastroenterology (SIGE), and the Italian Society of Internal Medicine (SIMI). Dig Liver Dis 2019; 51:1621–1632.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GlOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68:394–424.
Arnold M, Park JY, Camargo MC, Lunet N, Forman D, Soerjomataram I. Is gastric cancer becoming a rare disease? A global assessment of predicted incidence trends to 2035. Gut 2020; 69:823–829.
De Francesco V, Alicante S, Amato A, Frazzoni L, Lombardi G, Manfredi G, et al. Quality performance measures in upper gastrointestinal endoscopy for lesion detection: Italian AIGO-SIED-SIGE joint position statement. Dig Liver Dis 2022; 54:1479–1485.
Bisschops R, Areia M, Coron E, Dobru D, Kaskas B, Kuvaev R, et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48:843–864.
Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 2019; 51:365–388.
Romano M, Gravina AG, Eusebi LH, Pellegrino R, Palladino G, Frazzoni L, et al.; Members of SIGE. Management of Helicobacter pylori infection: guidelines of the Italian Society of Gastroenterology (SIGE) and the Italian Society of Digestive Endoscopy (SIED). Dig Liver Dis 2022; 54:1153–1161.
Rugge M, Meggio A, Pravadelli C, Barbareschi M, Fassan M, Gentilini M, et al. Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: a 5-year prospective study of 1755 patients. Gut 2019; 68:11–17.
Kotilea K, Bontems P, Touati E. Epidemiology, diagnosis and risk factors of Helicobacter pylori infection. Adv Exp Med Biol 2019; 1149:17–33.
Tucci A, Tucci P, Marchegiani A, Papadopoli G, Spada A, Cristino M, et al. Mt 21-42: Development and validation of an automatic device proposed for the endoscopic diagnosis of Helicobacter pylori infection and atrophic gastritis. Digestion 2005; 72:33–42.
Ummarino A, Tucci FA, Pezzicoli G, Di Virgilio AP, Parigino D, Tucci P, et al. Value of real-time gastric juice analysis in upper gastrointestinal endoscopy. Minerva Gastroenterol Dietol 2015; 61:1–9.
Tucci A, Tucci P, Bisceglia M, Marchegiani A, Papadopoli G, Fusaroli P, et al. Real-time detection of Helicobacter Pylori infection and atrophic gastritis: comparison between conventional methods and a novel device for gastric juice analysis during endoscopy. Endoscopy 2005; 37:966–976.
Tucci A, Bisceglia M, Rugge M, Tucci P, Marchegiani A, Papadopoli G, et al. Clinical usefulness of gastric-juice analysis in 2007: the stone that the builders rejected has become the cornerstone. Gastrointest Endosc 2007; 66:881–890.
Costamagna G, Zullo A, Bizzotto A, Spada C, Hassan C, Riccioni ME, et al. Real-time diagnosis of H pylori infection during endoscopy: accuracy of an innovative tool (EndoFaster). United European Gastroenterol J 2016; 4:339–342.
Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, et al. Optimizing the searching for H. pylori in clinical practice with EndoFaster. Dig Liver Dis 2021; 53:772–775.
Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, et al. Real-time determination of gastric juice pH with EndoFaster® for atrophic gastritis assessment. Dig Liver Dis 2022; 54:1646–1648.
Cazzato M, Esposito G, Galli G, Pilozzi E, Lahner E, Corleto VD, et al. Diagnostic accuracy of EndoFaster® and Narrow-Band Imaging endoscopy in patients with impaired gastric acid secretion: a real-time prospective study. Gastroenterol Res Pract 2021; 2021.
Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, et al. Real-time gastric juice analysis with EndoFaster for H. pylori diagnosis: a large, multicentre study. Eur J Gastroenterol Hepatol 2022; 34:1121–1124.
HTA Italian Ministry of Health. Mini-HTA strumento automatico di endoscopia chimica - data was 31 July 2015. 2015. https://altems.unicatt.it/altems-Mini_HTA_Strumento_Automatico_di_endoscopia_chimica.pdf.
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 2003; 73:712–716.
Esposito G, Libanio D, Ligato I, Ramos Silva D, Dilagi E, Ortigao R, et al. EndoFaster and EGGIM for the diagnosis of Helicobacter pylori infection and advanced stages of gastrointestinal metaplasia. UEG J 2022; 10:353–354.
Vasapolli R, Ailloud F, Suerbaum S, Neumann J, Koch N, Macke L, et al. Intraprocedural gastric juice analysis as compared to rapid urease test for real-time detection of Helicobacter pylori. World J Gastroenterol 2023; 29:1494–1503.
Conti Bellocchi MC, Gasparini E, Bobba V, Bernardoni L, Crinò SF, Fino V, et al. Validation of Endofaster® as a substitute of histology in Helicobacter pylori detection. Dig Liver Dis 2023; 55(Suppl 2):S175.
Carretero-Barrio I, Rodajo-Fernandez T, Romio E, Sanchez-Rodriguez E, Vázquez-Sequeiros E, Perna C, et al. Comparison between real-time ammonium and pH measurement, immunohistochemistry, and histochemistry for the diagnosis of Helicobacter pylori. J Clin Gastroenterol 2022; 56:e263–e267.
Piccirelli S, Grassano A, Spada C. Diagnostic accuracy of Endofaster® in detection of H. pylori infection compared to gold standard biopsy in routine endoscopy. Dig Liver Dis 2020; 52(Suppl 2):S76.
Zullo A. Diagnosis of H. pylori with Endofaster. J Clin Gastroenterol 2022; 56:464.
Esposito G, Libânio D, Ligato I, Ramos Silva D, Dilaghi E, Ortigão R, et al. Real-time assessment of H. pylori during the endoscopic assessment of individuals with gastric intestinal metaplasia: a possible way to reduce the burden of care. Eur J Gastroenterol Hepatol 2023; 35:1154–1158.
Siavoshi F, Saniee P, Khalili-Samani S, Hosseini F, Malakutikhah F, Mamivand M, et al. Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination. Ann Transl Med 2015; 3:11.
Januszewicz W, Kaminski MF. Quality indicators in diagnostic upper gastrointestinal endoscopy. Ther Adv Gastroenterol 2020; 13:175628482091669–175628482091619.
Januszewicz W, Wieszczy P, Bialek A, Karpinska K, Szlak J, Szymonik J, et al. Endoscopist biopsy rate as a quality indicator for outpatient gastroscopy: a multicenter cohort study with validation. Gastrointest Endosc 2019; 89:1141–1149.
Spada C, Piccirelli S. Real-time diagnosis of Helicobacter pylori during endoscopy by gastric juice analysis. Methods Mol Biol 2021; 2283:21–27.
Rugge M, Correa P, Dixon MF, Fiocca R, Hattori T, Lechago J, et al. Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther 2002; 16:1249–1259.
Capelle LG, de Vries AC, Haringsma J, Ter Borg F, de Vries RA, Bruno MJ, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc 2010; 71:1150–1158.
Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis The updated Sydney system International workshop on the histopathology of gastritis, Houston 1994. Am J Surg Pathol 1996; 20:1161–1181.
Live flukes and Helicobacter pylori. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, Lyon, 7–14 June 1994. IARC Monogr Eval Carcinog Risks Hum 1994; 61:1–241.
Zullo A, Germanà B, Galliani E, Iori A, De Pretis G, Manfredi G, et al. Real-time EndoFaster improves Helicobacter pylori detection in chronic active gastritis. J Clin Pathol 2022; 75:572–574.
Rettura F, Bronzini F, Campigotto M, Lambiase C, Pancetti A, Berti G, et al. Refractory gastroesophageal reflux disease: a management update. Front Med (Lausanne) 2021; 8:765061.
Januszewicz W, Hartley J, Waldock W, Roberts G, Alias B, Hobson A, et al. Endoscopic measurement of gastric pH is associated with persistent acid reflux in patients treated with proton pump inhibitors for gastroesophageal reflux disease. UEG J 2019; 7:1389–1398.
Rodríguez de Santiago E, Dinis-Ribeiro M, Pohl H, Agrawal D, Arvanitakis M, Baddeley R, et al. Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) positions Statement. Endoscopy 2022; 54:797–826.
Bortoluzzi F, Sorge A, Vassallo R, Montalbano LM, Monica F, La Mura S, et al.; Italian Association of Hospital Gastroenterologists and Digestive Endoscopists (AIGO). Sustainability in gastroenterology and digestive endoscopy: position paper from the Italian Association of Hospital Gastroenterology and Digestive Endoscopy (AIGO). Dig Liver Dis 2022; 54:1623–1629.
Lopes C, Almeida TC, Pimentel-Nunes P, Dinis-Ribeiro M, Pereira C. Linking dysbiosis to precancerous stomach through inflammation: deeper than and beyond imaging. Front Immunol 2023; 14:1134785.

Auteurs

Angelo Zullo (A)

Gastroenterology Unit, 'Nuovo Regina Margherita' Hospital.

Bruno Annibale (B)

Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, Rome, Italy.

Mario Dinis-Ribeiro (M)

Gastroenterology Department, Portuguese Oncology Institute of Porto, and Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal.

Gianluca Fanchellucci (G)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele and.
Endoscopy Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.

Gianluca Esposito (G)

Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, Rome, Italy.

Cesare Hassan (C)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele and.
Endoscopy Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.

Classifications MeSH