H. pylori plays a major role in gastroduodenal diseases. Since its incidence is decreasing in developed countries, gastric biopsies were negative in several patients managed in clinical practice. We tested whether EndoFasterⓇ − a device allowing real-time H. pylori detection by gastric juice analysis – may optimize the need of biopsies.
In this prospective, multicentre study, the accuracy of EndoFasterⓇ for H. pylori detection was computed by using histology of gastric biopsies as a gold standard.
Data of 525 consecutive patients were available, including 90 (17.1%) patients with infection. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of EndoFasterⓇ were 87%, 84%, 53%, 97% and 85%, respectively. The overall accuracy of test was not affected neither by ongoing proton pump inhibitor therapy nor by previous eradication therapy. By using EndoFasterⓇ in our series, biopsy sampling could have been eventually avoided in a total of 279 patients, accounting for a reduction of 42.3%, accepting the risk of only 8 false negative cases.
The very high NPV of EndoFasterⓇ might allow to safely halve the need of taking gastric biopsies in unselected patients managed in clinical practice, avoiding an unavailing consume of health resources.
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- Guidelines for the management of Helicobacter pylori infection in Italy: the III working group consensus report 2015.Dig Liver Dis. 2015; 47: 903-912
- Management of Helicobacter pylori infection-the Maastricht V/florence consensus report.Gut. 2017; 66: 6-30
- Helicobacter pylori.Am J Gastroenterol. 1994; 89: S116-S128
- Prevalence of lesions detected at upper endoscopy: an Italian survey.Eur J Int Med. 2014; 25: 772-776
- Diagnosis of Helicobacter pylori by invasive test: histology.Ann Transl Med. 2015; 3: 10
- Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination.Ann Transl Med. 2015; 3: 11
- Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test.World J Gastroenterol. 2012; 18: 44-48
- Diagnostic of Helicobacter pylori infection.Helicobacter. 2016; 21: 8-13
- Detection of gastric precancerous conditions in daily clinical practice: a nationwide survey.Helicobacter. 2014; 19: 417-424
- Clinical usefulness of gastric-juice analysis in 2007: the stone that the builders rejected has become the cornerstone.Gastrointest Endosc. 2007; 66: 881-890
- Real-time diagnosis of H. pylori infection during endoscopy: accuracy of an innovative tool (EndoFaster).UEG Journal. 2015; 4: 339-342
- 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
- Convolutional neural networks in the computer-aided diagnosis of Helicobacter pylori infection and non-causal comparison to physician endoscopists: a systematic review with meta-analysis.Ann Gastroenterol. 2021; 34: 20-25
- A systematic review of the role of non-magnified endoscopy for the assessment of H. pylori infection.Endosc Int Open. 2020; 8: E105-E114
Italian Ministry of Health. Mini-HTA strumento automatico di endoscopia chimica - data was 31 July 2015 https://altems.unicatt.it/altems-Mini_HTA_Strumento_Automatico_di_endoscopia_chimica.pdf. 21 July 2015.
- Gastrointestinal endoscopy in patients on anticoagulant therapy and antiplatelet agents.Ann Gastroenterol. 2017; 30: 7-14
- What gastroenterologists should know about direct oral anticoagulants.Dig Liver Dis. 2020; 52: 1115-1125
- Helicobacter pylori diagnosis in patients with liver cirrhosis.Dig Liv Dis. 2003; 34: 556-570
Published online: March 03, 2021
Accepted: February 1, 2021
Received: January 19, 2021
Supports: No grant was received for this study.
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.