AUTHOR=Quach Duc Trong , Aoki Rika , Iga Akiko , Le Quang Dinh , Kawamura Toru , Yamashita Ken , Tanaka Shinji , Yoshihara Masaharu , Hiyama Toru 

TITLE=Diagnostic Accuracy of H. pylori Status by Conventional Endoscopy: Time-Trend Change After Eradication and Impact of Endoscopic Image Quality

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.830730

DOI=10.3389/fmed.2021.830730

ISSN=2296-858X

ABSTRACT=<sec><title>Aim</title><p>To assess the time trend of diagnostic accuracy of pre- and post-eradication <italic>H. pylori</italic> status and interobserver agreement of gastric atrophy grading.</p></sec><sec><title>Methods</title><p>A series 100 of conventional endoscopic image sets taken from subjects undergoing gastric cancer screening at a polyclinic were evaluated by 5 experienced assessors. Each assessor independently examined endoscopic findings according to the Kyoto classification and then determined the <italic>H. pylori</italic> status (never, current, or past infected). Gastric atrophy was assessed according to the Kimura-Takemoto classification and classified into 3 grades (none/mild, moderate, or severe). The image series that ≥3 assessors considered to have good quality were arbitrarily defined as high-quality image (HQI) series, and the rest were defined as low-quality image (LQI) series.</p></sec><sec><title>Results</title><p>The overall diagnostic accuracy of <italic>H. pylori</italic> status was 83.0%. It was lowest in subjects with current infection (54%), gradually increased at 1 year (79%, <italic>P</italic> &lt; 0.001) and 3 years (94.0%, <italic>P</italic> = 0.002), but then did not significantly change at 5 years (91.0%, <italic>P</italic> = 0.420) after eradication. The rate of LQI series was 28%. The overall diagnostic accuracy of <italic>H. pylori</italic> status dropped from 88.9% to 67.9% (<italic>P</italic> &lt; 0.001), and the mean kappa value on gastric atrophy grading dropped from 0.730 to 0.580 (<italic>P</italic> = 0.002) in the HQI and LQI series, respectively.</p></sec><sec><title>Conclusions</title><p>Diagnostic accuracy of <italic>H. pylori</italic> status increased over time after eradication. LQI series badly affected the diagnostic accuracy of <italic>H. pylori</italic> status and the level of agreement when grading gastric atrophy.</p></sec>