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.
Dr Eylul Sitesi and colleagues from Turkey compared standard endoscopy with magnifying endoscopy for the diagnosis of Helicobacter pylori gastritis.
In addition, the researchers determined whether gastritis can be diagnosed based on findings at magnification endoscopy.
The team enrolled a total of 129 patients into the study.
Erythema, erosions, prominent area gastrica, nodularity, and regular arrangement of collecting venules were investigated by standard endoscopy.
Standard endoscopy was followed by magnifying endoscopy in all patients, and repeated in 55 patients after indigo carmine spraying.
|None of the standard endoscopic features had a sensitivity of more than 70% for H pylori gastritis|
The researchers found that none of the standard endoscopic features showed a sensitivity of more than 70% for H pylori gastritis, except regular arrangement of collecting venules pattern analysis.
Absence of a corporal regular arrangement of collecting venules pattern had a 86% sensitivity, and 83% specificity for predicting H pylori infection.
Under magnification, the sensitivity and specificity of regular corporal pattern for predicting normal histology were 90% and 94%, respectively.
The team found 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 team noted that the values for irregularly arranged antral ridge pattern for the prediction of antral gastritis were 89% and 65%, respectively.
Indigo carmine staining increased sensitivity and specificity up to 98% and 100% for corporal gastritis, and up to 88% and 75% for antral gastritis, respectively.
Indigo carmine staining significantly increases the detection of intestinal metaplasia.
Dr Sitesi’s team concluded, “High resolution magnifying is superior to standard endoscopy for the diagnosis of H. pylori gastritis.”
“It is also superior in identifying specific histopathologic features such as atrophy and intestinal metaplasia seems possible.”