Abstract

Helicobacter pylori infection is a class I carcinogen that can lead to gastric cancer. Early diagnosis and eradication of H. pylori infection are important to eliminate the risk of gastric cancer. Several invasive diagnostic techniques require biopsy samples, resulting in avoidable injury and medical expense. Furthermore, due to the localized distribution of H. pylori, random biopsies are not always reliable in diagnosing H. pylori infection. This article aimed to review endoscopic findings and new endoscopic options for the diagnosis of H. pylori infection. Using conventional white light imaging (WLI) and image-enhanced endoscopy (IEE), the endoscopic features associated with histological changes have increasingly become apparent. Real-time endoscopy is essential to make a diagnosis of H. pylori infection and allow targeted biopsy. Image-enhanced endoscopy (IEE), such as narrow-band imaging (NBI), linked color imaging (LCI), and blue laser imaging (BLI), enhances visualization of the surface vascular pattern and provides accurate diagnostic performance in H. pylori infection, as well as gastric neoplastic lesions, compared to conventional white light endoscopy. In conclusion, the new endoscopic technologies could be used in current practice with conventional white light endoscopy for accurate and real-time diagnosis of H. pylori infection and pre-cancerous lesions.

Highlights

  • Helicobacter pylori infection is the leading cause of chronic gastritis, and it is classified as a class I carcinogen of gastric cancer by the World Health Organization (WHO) (Marshall, 2008)

  • Using conventional white light imaging (WLI) and image-enhanced endoscopy (IEE), the endoscopic features associated with histological changes have increasingly become apparent

  • The new endoscopic technologies could be used in current practice with conventional white light endoscopy for accurate and real-time diagnosis of H. pylori infection and pre-cancerous lesions

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Summary

Introduction

Helicobacter pylori infection is the leading cause of chronic gastritis, and it is classified as a class I carcinogen of gastric cancer by the World Health Organization (WHO) (Marshall, 2008). Real-time endoscopy along with conventional white light imaging WLI) and image-enhanced endoscopic (IEE) techniques, such as narrow-band imaging (NBI), linked color imaging (LCI) and blue laser imaging (BLI), appear to have important roles in clinical practice to identify H. pylori-infected status (Malfertheiner et al, 2007). Real-time endoscopy has become an important tool for detecting H. pylori infection. It provides additional endoscopic information on gastric mucosal abnormalities and results in unnecessary mucosal injury and medical costs. Narrow-band illumination is absorbed by hemoglobin, and the shortened wavelength penetrates the surface tissue This technique results in enhanced contrast of superficial microvessels and mucosal surface (East et al, 2016). The high-intensity contrast imaging produced by magnifying blue laser imaging (M-BLI) provides clear visualization of microvascular and microsurface patterns like M-NBI

Marginal turbid band
Round homogenous sized pits and presence of RAC
Findings
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