To reduce the incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer, Helicobacter pylori eradication therapy has been endorsed.
It is not unusual for such patients to be H. pylori negative after eradication or for other reasons.
If it were possible to predict H. pylori status using endoscopy alone, it would be very useful in clinical practice.
To clarify the accuracy of endoscopic judgment of H. pylori status, Dr Kazuyoshi Yagi and colleagues from Japan evaluated it in the stomach after endoscopic submucosal dissection of gastric cancer.
|Interobserver agreement was substantial for NBI-magnifying endoscopy|
The researchers enrolled 56 patients treated by endoscopic submucosal dissection.
The diagnostic criteria for H. pylori status by conventional endoscopy and narrow-band imaging (NBI)-magnifying endoscopy were decided, and H. pylori status was judged by 2 endoscopists.
Based on the H. pylori stool antigen test as a diagnostic gold standard, conventional endoscopy and NBI-magnifying endoscopy were compared for their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
The team reported that interobserver agreement was moderate for conventional endoscopy, and substantial for NBI-magnifying endoscopy.
The sensitivity, specificity, PPV, and NPV were 0.79, 0.52, 0.70, and 0.63 for conventional endoscopy and 0.91, 0.83, 0.88, and 0.86 for NBI-magnifying endoscopy, respectively.
Dr Yagi's team concludes, "Prediction of H. pylori status using NBI-magnifying endoscopy is practical, and interobserver agreement is substantial."