Blue Laser Imaging and Magnification Endoscopy as a Tool for the Detection of Helicobacter pylori Infected Mucosa

Abstract

Background: There are multiple diagnostic methods for the detection of H. pylori; however, because most are not cost-effective and have low sensibility and specificity, gastric biopsy remains the gold standard for diagnosis. H. pylori’s patchy distribution in the gastric mucosa requires multiple biopsy samples to accurately diagnose infection. This study’s objective is to identify the diagnostic value of using BLI-Bright with magnification endoscopy as a tool for guided biopsy sampling in patients with suspected H. pylori infection. Methods: This study was conducted by retrospective analysis of 200 case files of patients who underwent upper endoscopy at Christus Muguerza Hospital Sur in Monterrey, Mexico between August 2016 and June 2018. One hundred ninety-three patient files met the selection criteria. To establish the diagnostic significance of occupied/ unoccupied gastric pits, sensibility, specificity, and positive and negative predictive values were calculated based on histological findings. Results: Predicting H. pylori infection in occupied/ unoccupied pits has a sensitivity of 66.00%, specificity of 95.10%, a positive predictive value of 85.50%, and a negative predictive value of 88.89%. Analysis of gastric pits using BLI-Bright with magnification endoscopy is more sensitive and specific than rapid urease testing for the diagnosis of H. pylori. Conclusions: Given its relatively high negative predictive value, finding empty gastric pits suggests a low probability of finding H. pylori. Blue Laser Imaging (BLI)-Bright with magnification endoscopy is not a replacement for histologic examination, but rather a tool to help select potentially infected areas of the stomach based on the appearance of gastric pits.