Published online Jan 16, 2020. doi: 10.4253/wjge.v12.i1.23
Peer-review started: June 29, 2019
First decision: August 2, 2019
Revised: August 13, 2019
Accepted: November 18, 2019
Article in press: November 18, 2019
Published online: January 16, 2020
Processing time: 172 Days and 18 Hours
Helicobacter pylori (H. pylori) infection and atrophic gastritis are linked to gastric carcinogenesis. The endoscopic diagnosis of H. pylori infection and gastric atrophy is challenging, requiring histological confirmation; however, sampling errors might occur.
Digital chromoendoscopy with optical magnification improved the identification of mucosal superficial and vascular patterns in the gastric mucosa and might provide a more accurate endoscopic visual impression of the gastric mucosa.
The main objective of the study was to evaluate digital chromoendoscopy with optical magnification for the diagnosis of normal gastric mucosa, H. pylori associated gastritis and atrophic gastritis.
This was a cross-sectional, nonrandomized, single-center study in which consecutive patients with functional dyspepsia were evaluated via esophagogastroduodenoscopy using a high definition endoscope with digital chromoendoscopy and optical magnification for the endoscopic diagnosis of H. pylori associated gastritis and atrophic gastritis. The endoscopic visual impression was compared to H. pylori stool antigen test and histological analysis.
We described a high sensitivity and accuracy for predicting normal gastric mucosa and H. pylori associated gastritis, with a high inter and intraobserver agreement. Atrophic gastritis was detected with a low sensitivity, and further studies are required to determine if endoscopic diagnosis of atrophic gastritis is feasible.
In our study, esophagogastroduodenoscopy with digital chromoendoscopy and optical magnification enable the identification of histological changes in the gastric mucosa of consecutive patients with functional dyspepsia.
We encourage a randomized multicenter trial evaluating high definition white light endoscopy versus digital chromoendoscopy with optical magnification for the evaluation of the gastric mucosa of dyspeptic patients, in order to determine the clinical practice applicability of these techniques. Further studies are needed to determine if endoscopic diagnosis of atrophic gastritis is feasible.