Linked color imaging confers benefits in profiling H. pylori infection in the stomach.

Sun X1,2, Bi Y1, Nong B3, Hu D4, Sun X5, Chen H6, Xu Y1, Liu Y1.

Endosc Int Open. 2019 Jul;7(7):E885-E892. doi: 10.1055/a-0895-5377. Epub 2019 Jul 3.

Background & aims: There is a high prevalence of Helicobacter pylori infection. White light endoscopy (WLE) can be used for evaluating the mucosal lesions, but it does not have high diagnostic efficiency. Linked color imaging (LCI) is a newly developed endoscopic imaging technique. The aim of this study was to compare LCI with WLE in detecting and staging H. pylori infection in the stomach in arandomized controlled clinical trial.

Patients and methods: A total of 253 patients who had indications for gastroduodenoscopy were enrolled and randomized into Group A (n = 127), who underwent WLE followed by LCI, and Group B (n = 126), who underwent LCI followed by WLE. Clinical data were collected and the diagnostic accuracy of WLE and LCI was calculated and compared.

Results: The overall diagnostic accuracy of WLE and LCI for H. pylori infection was 31.5 % (n = 40) and 50.4 % (n = 64) in Group A (P = 0.001), and 36.5% (n = 46) and 49.2% (n = 62) in Group B (P = 0.029). In both groups, LCI had higher sensitivity, specificity, and Youden index scores than WLE. Four stages were defined in the course of H. pylori infection in the stomach. LCI staging results were more highly consistent with pathological staging than were WLE staging results (kappa value 0.772 vs. 0.516). The LCI observations were closely correlated with the pathology.

Conclusions: LCI had a higher diagnostic efficacy for H. pylori infection in the stomach. Endoscopic color features under LCI can help to stage and profile H. pylori-associated gastritis.

1 Department of Gastroenterology, the Fifth Clinical Center of Chinese PLA General Hospital (307 Hospital), Beijing, China
2 Department of Internal Medicine, Clinic of August First Film Studio, Beijing, China
3 Department of Gastroenterology and Hepatology, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
4 Department of Gastroenterology, the Second Affiliated Hospital of Soochow University, Suzhou, China
5 Department of Gastroenterology and Hepatology, Shanghai Tenth People’s Hospital, Shanghai, China
6 Department of Gastroenterology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.