title: Improved Detection of Helicobacter pylori Infection and Premalignant Gastric Mucosa Using "Site Specific Biopsy": a Randomized Control Clinical Trial.
abstract: BACKGROUND
  Helicobacter pylori infection and premalignant gastric mucosa can be reliably identified using conventional narrow band imaging (C-NBI) gastroscopy. The aim of our study was to compare standard biopsy with site specific biopsy for diagnosis of H. pylori infection and premalignant gastric mucosa in daily clinical practice.
  
  
  METHODS
  Of a total of 500 patients who underwent gastroscopy for investigation of dyspeptic symptoms, 250 patients underwent site specific biopsy using C-NBI (Group 1) and 250 standard biopsy (Group 2). Sensitivity, specificity, and positive and negative predictive values were assessed. The efficacy of detecting H. pylori associated gastritis and premalignant gastric mucosa according to the updated Sydney classification was also compared.
  
  
  RESULTS
  In group 1 the sensitivity, specificity, positive and negative predictive values for predicting H. pylori positivity were 95.4%, 97.3%, 98.8% and 90.0% respectively, compared to 92.9%, 88.6%, 83.2% and 76.1% in group 2. Site specific biopsy was more effective than standard biopsy in terms of both H. pylori infection status and premalignant gastric mucosa detection (P<0.01).
  
  
  CONCLUSIONS
  Site specific biopsy using C-NBI can improve detection of H. pylori infection and premalignant gastric mucosa in daily clinical practice.
authors.affiliation: Department of Surgery, Institute of Medicine, Suranaree University of Technology, Nakhon Rachasima, Thailand E-mail : taweesak.t@sut.ac.th.
authors.forename: Taweesak
authors.initials: T
authors.lastname: Tongtawee
authors.forename: Chavaboon
authors.initials: C
authors.lastname: Dechsukhum
authors.forename: Wilairat
authors.initials: W
authors.lastname: Leeanansaksiri
authors.forename: Soraya
authors.initials: S
authors.lastname: Kaewpitoon
authors.forename: Natthawut
authors.initials: N
authors.lastname: Kaewpitoon
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Loyd
authors.forename: Likit
authors.initials: L
authors.lastname: Matrakool
authors.forename: Sukij
authors.initials: S
authors.lastname: Panpimanmas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000382:microbiology*; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000382:microbiology; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult