1. Comparative study of magnifying narrow-band imaging and conventional white light endoscopy in the diagnosis of Helicobacter pylori status after eradication therapy.
- Author
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Tahara T, Horiguchi N, Yamada H, Yoshida D, Terada T, Okubo M, Funasaka K, Nakagawa Y, Shibata T, and Ohmiya N
- Subjects
- Adult, Aged, Aged, 80 and over, Endoscopy, Digestive System methods, Female, Gastritis drug therapy, Gastritis microbiology, Helicobacter Infections drug therapy, Helicobacter Infections microbiology, Humans, Light, Male, Middle Aged, Narrow Band Imaging methods, Predictive Value of Tests, Prospective Studies, Radiographic Magnification methods, Sensitivity and Specificity, Young Adult, Endoscopy, Digestive System statistics & numerical data, Gastritis diagnostic imaging, Helicobacter Infections diagnostic imaging, Helicobacter pylori, Narrow Band Imaging statistics & numerical data, Radiographic Magnification statistics & numerical data
- Abstract
Predicting Helicobacter pylori (Hp) status by endoscopic finding would be useful in recent clinical condition that the use of proton-pump inhibitors, anti-platelet, and anti-coagulant have become widespread. We aimed to elucidate the diagnostic accuracy of magnifying narrow-band imaging (M-NBI) endoscopy in distinguishing Hp status in patients with or without history of successful Hp eradication and compare this accuracy to the diagnostic accuracy of conventional white light (WL) endoscopy.Two hundred seven endoscopic examinations before and after Hp eradication were performed in prospective 163 patients. Endoscopic images by using the M-NBI and conventional WL were stored electronically and randomly allocated to 2 readers for evaluation. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were assessed by reference to Hp status assessed by conventional clinical test.Sensitivity, specificity, PPV, NPV, and accuracy for predicting Hp status for the conventional WL was 72.2%, 75.5%, 72.2%, 75.5%, and 73.9% for the first reader; 86.6%, 57.3%, 64.1%, 82.9%, and 71.0% for the second reader. On the other hand, sensitivity, specificity, PPV, NPV, and accuracy for predicting Hp status for the M-NBI was 96.9%, 93.6%, 93.1%, 97.1%, and 95.2% for the first reader; 92.8%, 93.6%, 92.8%, 93.6%, and 93.2% for the second reader, respectively. The diagnostic accuracy of M-NBI was significantly higher than that of WL (P < .0001 for both readers). Inter-observer agreement of M-NBI (k = 0.83) was also better than that of WL (k = 0.53).M-NBI was capable of distinguishing Hp status before and after eradication therapy.
- Published
- 2019
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