Association between mucosal surface pattern under near focus technology and Helicobacter pylori infection

Table 1 Patient’s characteristics

Characteristics	Total (%)	H. pylori + (%) 47 (25.1%)	H. pylori-(%) 140 (74.9%)	P value
Age, yr				0.580
< 50	85 (45.5)	23 (48.9)	62 (44.3)
> 50	102 (54.5)	24 (51.1)	78 (55.7)
Gender				0.629
Male	74 (39.5)	20 (42.5)	54 (38.6)
Female	113 (60.5)	27 (57.5)	86 (61.4)
Symptoms
Epigastric pain	83 (44.4)	26 (55.3)	57 (40.7)	0.081
Heartburn	40 (21.4)	9 (19.1)	31 (22.1)	0.665
Previous treated H. pylori infection	42 (22.5)	17 (36.2)	25 (17.9)	0.009

Chi-square test. Helicobacter pylori: H. pylori.

Table 2 Endoscopic findings with standard focus high definition white light and association with Helicobacter pylori infection

Location	Feature	Patients	Sensitivity % (95%CI)	Specificity % (95%CI)	PPV % (95%CI)	NPV % (95%CI)	AUC % (95%CI)	Accuracy % (95%CI)
Body	Erythema	75	80.9 (66.7-90.9)	73.6 (65.5-80.7)	50.7 (38.9-62.4)	92.0 (85.3-62.4)	0.77 (0.70-0.84)	75.4 (68.6-81.4)
	Erosion	16	10.6 (3.6-23.1)	92.1 (86.4-96.0)	31.3 (11.0-58.7)	75.4 (68.3-81.7)	0.51 (0.46-0.56)	71.7 (64.6-78.0)
	Exudate	4	6.4 (1.3-17.5)	99.3 (96.1-100)	75.0 (19.4-99.4)	76.0 (69.1-82.0)	0.53 (0.49-0.56)	75.9 (69.2-81.9)
	Atrophy	15	19.1 (9.1-33.3)	95.7 (90.9-98.4)	60.0 (71.0-83.9)	77.9 (71.0-83.9)	0.57 (0.52-0.63)	76.5 (69.7-82.3)
	Nodularity	7	6.4 (1.3-17.5)	97.1 (92.8-99.2)	42.9 (9.9-81.6)	75.6 (68.6-81.6)	0.52 (0.48-0.56)	74.3 (67.4-80.4)
Antrum	Erythema	87	72.3 (57.4-84.4)	62.1 (53.6-70.2)	39.1 (28.8-50.1)	87.0 (78.8-92.9)	0.67 (0.60-0.75)	64.7 (57.4-71.5)
	Erosion	38	21.3 (10.7-35.7)	80.0 (72.4-86.3)	26.3 (13.4-43.1)	75.2 (67.4-81.9)	0.51 (0.44-0.57)	65.2 (57.9-72.0)
	Exudate	1	2.1 (0.5-11.3)	100 (97.4-100)	100 (2.5-100)	75.3 (68.4-81.3)	0.51 (0.49-0.53)	75.4 (68.6-81.4)
	Atrophy	16	23.4 (12.3-38.0)	96.4 (91.9-98.8)	68.8 (41.3-89.0)	78.9 (72.1-84.8)	0.60 (0.54-0.66)	78.1 (71.4-83.8)
	Nodularity	7	10.6 (3.5-23.1)	98.6 (94.9-99.8)	71.4 (29.0-96.3)	76.7 (69.8-82.6)	0.55 (0.50-0.59)	76.5 (69.7-82.3)

CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under receiver operating characteristic curve.

Table 3 Association between classifications and Helicobacter pylori infection of the gastric body

RAC	Classification	Helicobacter pylori status (%)		Total (%)
		Negative	Positive
RAC +
	Type 1	99 (94.3)	6.0 (5.7)	105 (56.2)
RAC -
	Type 2	35 (61.4)	22 (38.6)	57 (30.5)
	Type 3	6 (33.3)	12 (66.7)	18 (9.6)
	Type 4	0 (0.0)	7 (100.0)	7 (3.7)
	Types 2, 3 and 4	41 (50)	41 (50)	82 (43.8)
Total		140 (74.9)	47 (25.1)	187 (100)

Chi-square test; P < 0.001. RAC: Regular arrangement of collecting venules.

Table 4 Association between regular arrangement of collecting venules and Helicobacter pylori infection in patients with previous Helicobacter pylori treatment

Classification	Helicobacter pylori status (%)		Total (%)
	Negative	Positive
RAC +	21 (91.3)	2 (8.7)	23 (54.8)
RAC -	4 (21.1)	15 (78.9)	19 (45.2)
Total	25 (59.5)	17 (40.5)	42 (100)

RAC: Regular arrangement of collecting venules.

Table 5 Loss of regular arrangement of collecting venules with near focus high-definition examination in the gastric body and correlation with Helicobacter pylori infection

Loss of RAC	Sensitivity% (95%CI)	Specificity% (95%CI)	PPV % (95%CI)	NPV % (95%CI)	AUC % (95%CI)	Accuracy % (95%CI)
Overall (n = 187)	87.2 (74.3-95.2)	70.7 (62.4-78.1)	50.0 (38.7-61.3)	94.3 (88.0-97.9)	0.79 (0.73-0.85)	74.5 (67.6-80.5)
Patients without previous Helicobacter pylori treatment (n = 145)	86.7 (69.3-96.2)	67.8 (58.5-76.2)	41.3 (29.0-54.4)	95.1 (88.0-98.7)	0.77 (0.69-0.85)	71.7 (63.6-78.9)
Patients with previous Helicobacter pylori treatment (n = 42)	88.2 (63.6-98.5)	84.0 (63.9-95.5)	78.9 (54.4-93.9)	91.3 (72.0-98.9)	0.86 (0.73-0.97)	85.7 (71.5-94.6)

CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under receiver operating characteristic curve.

Table 6 Studies associating loss of regular arrangement of collecting venules with the presence of Helicobacter pylori

Ref.	Country	n	RAC +	Technology	Sensitivity	Specificity	PPV	NPV
Machado et al[16], 2008	Brazil	99	60	SD	96.9	88.1	-	-
Cho et al[15], 2013	Korea	617	254	S-HD	93.3	89.1	92.	90.6
Yagi et al[17], 2014	Japan	38	26	S-HD	79	52	70	63
Garcés-Durán et al[14], 2019	Spain	140	47	S-HD	100	48.9	47.3	100
Ebigbo et al[22], 2021	German	200	-	S-HD	80.7	57.4	40.0	89.4
Glover et al[21], 2021	United Kingdom	153	108	S-HD	78.4	64.3	40.0	90.7
Jang et al[18], 2020	Korea	115	-	NF + NBI	86.5	84.1	84.1	88.3
Yagi et al[11], 2002	Japan	557	161	ME	93.8	96.2	-	-
Nakagawa et al[12], 2003	Japan	92	23	ME	66.7	100	100	82.4
Anagnostopoulos et al[10], 2007	United Kingdom	95	64	ME	100	92.7	83.8	100
Yagi et al[17], 2014	Japan	49	30	ME + NBI	91	83	88	86
This study	Brazil	187	105	NF	87.2	70.7	50.0	94.3

RAC: Regular arrangement of collecting venules; S-HD: Standard high definition; ME: Magnification endoscopy; SD: Standard definition; NF: Near focus; PPV: Positive predictive value; NPV: Negative predictive value.