Endoscopy 2020; 52(S 01): S215
DOI: 10.1055/s-0040-1704673
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 11:00 – 11:30 Upper GI: Endoscopic diagnosis 3 ePoster Podium 6
© Georg Thieme Verlag KG Stuttgart · New York

DIAGNOSTIC ACCURACY OF ENDOFASTER IN DETECTION OF H. PYLORI INFECTION COMPARED TO GOLD STANDARD BIOPSY IN ROUTINE ENDOSCOPY

S Piccirelli
1   Fondazione Poliambulanza, Digestive Endoscopy Unit and Gastroenterology, Brescia, Italy
2   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterology, Rome, Italy
,
A Grassano
3   School of Medicine ‘Federico II of Naples’, Gastroenterology and Surgical Endoscopy, Department of Clinical Medicine and Surgery, Naples, Italy
,
C Spada
1   Fondazione Poliambulanza, Digestive Endoscopy Unit and Gastroenterology, Brescia, Italy
2   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterology, Rome, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

Auch verfügbar auf
 
 

    Aims H. pylori(HP) infection remains a major risk factor for gastric cancer.

    Biopsy is the gold standard diagnosis.Netherless, it is invasive and cost-consuming.

    Hence, a novel diagnositc tool named EndoFaster-EF, by NISO Biomed, has been tested for diagnosis of HP and hypochlorhydria based on detection of ammonium and pH levels in gastric-juice in real-time during endoscopy.

    Primary aim:to evaluate EF accuracy in diagnosis of HP infection vs gold-standard biopsy.

    Secondary aims:EF feasibility;correlation between pH levels and histological atrophy/Intestinal Metaplasia(IM);cut in terms of biopsies potentially avoidable using EF.

    Methods A consecutive series of 220patients referred to undergo OGD was prospectively enrolled in a single Center.

    During endoscopy, a Gastric-Juice-Analysis(GJA) on the aspirate was performed using EF.

    HP was considered present for ammonium concentration ≥ 74ppm.

    Three groups of pts were identified based on pH levels:Group1(pH ≤ 3), Group2(hypochlorhydrics:3 < pH < 4.5) and Group3(severely hypochloridrics: ≥ 4.5).

    Updated SydneySystem biopsy sampling was performed in all patients.

    Additional targeted biopsies were performed if visible lesions were found.

    EF accuracy in HP detection was calculated.

    Correlation between pH and atrophy/IM was evaluated in patients not taking PPI in the previous 2 weeks.

    Results 204/220 patients underwent a complete analysis(histology-HIS and GJA).

    28 patients resulted EF + HIS +,17 EF + HIS-,5 EF-HIS +,and 154 EF-HIS-.

    EF Sensitivity, specificity, PPV and NPV in HP detection were 85%, 90%, 62% e 97% respectively, accuracy being equal to 89%(p < 0.0000001,CI 95%).

    EF feasibility was 93%.

    Of 111 PPI-off patients, atrophy was found in 12.6% of patients of Group1 (n = 103;92.8%), in 50% of patients of Group2 (n = 2;1.8%) and 66% of patients of Group3 (n = 6;5,4%).

    Overall, biopsy sampling would have been avoided in 146/204 patients, with a cut of biopsies of 71,5% and 77,9% applying EF for detection of precancerous lesions and HP infection, respectively.

    Conclusions EF resulted feasible and accurate in excluding HP infection(97% NPV), may selecting patients not deserving biopsy sampling, thus reducing useless biopsies.


    #