Endoscopic Diagnosis of Helicobacter Pylori Infection by the Arrangement of Collecting Venules in Patients Treated with Proton Pump Inhibitors: A Multicenter Validation trial in european Population

Aims Regular arrangement of collecting venules (RAC) in gastric mucosa accurately identifies patients without Helicobacter pylori (H pylori) infection. The aim of our study was to evaluate the value of RAC in patients under proton pump inhibitors (PPIs) and the reproducibility in a European country.

Methods A multicenter prospective study with high-definition endoscopes without magnification was performed by 4 endoscopists. Patients treated with PPIs were not excluded. Image capture of the lesser gastric curvature and gastric biopsies were performed during procedures. Images were evaluated by all the operators and reevaluated 2 weeks later in a different order. A set of 20 images was used for the training phase. Presence of starfish-like minute points regularly distributed throughout lesser curvature on the selected pictures was considered RAC+.

Results 174 patients were included and 85 (48.9 %) were under PPIs. H pylori infection was diagnosed in 29 patients (16.7 %): 10/85 with PPIs and 19/89 without (11.8 % vs. 21.3 %; p = 0.09). 25.9 % of patients taking PPIs were RAC+, and all of them were free of H pylori infection, with a sensitivity and NPV of 100 %. Patients with RAC+ pattern were significantly younger (45.8±12.9 vs. 56.1±16.1 years; p = 0.040). Kappa values for inter-observer and intra-observer agreement were substantial (0.786) and excellent (0.906), respectively.

Conclusions The endoscopic diagnosis of H Pylori by RAC is an easy-to-learn and highly reproducible technique, even when the patient has taken PPIs. Our results warrant the incorporation of RAC as a real-time diagnostic method for H Pylori infection in Western countries.

Citation: Garcés-Duran R, Galdin-Ferreyra M, Delgado-Guillena P et al. OP51 ENDOSCOPIC DIAGNOSIS OF HELICOBACTER PYLORI INFECTION BY THE ARRANGEMENT OF COLLECTING VENULES IN PATIENTS TREATED WITH PROTON PUMP INHIBITORS: A MULTICENTER VALIDATION TRIAL IN EUROPEAN POPULATION. Endoscopy 2021; 53: S23.

Publication History

Article published online:
19 March 2021