title: Diagnostic Performance of Magnifying Endoscopy for Helicobacter pylori Infection: A Meta-Analysis.
abstract: BACKGROUND
  Diagnosis of Helicobacter pylori (H. pylori) infection using magnifying endoscopy offers advantages over conventional invasive and noninvasive tests.
  
  
  OBJECTIVE
  This meta-analysis aimed to assess the diagnostic performance of magnifying endoscopy in the prediction of H. pylori infection.
  
  
  METHODS
  A literature search of the PubMed, Medline, EMBASE, Science Direct and the Cochrane Library databases was performed. A random-effects model was used to calculate the diagnostic efficiency of magnifying endoscopy for H. pylori infection. A summary receiver operator characteristic curve was plotted, and the area under the curve (AUC) was calculated.
  
  
  RESULTS
  A total of 18 studies involving 1897 patients were included. The pooled sensitivity and specificity of magnifying endoscopy to predict H. pylori infection were 0.89 [95% confidence interval (CI) 0.87-0.91] and 0.82 (95%CI 0.79-0.85), respectively, with an AUC of 0.9461. When targeting the gastric antrum, the pooled sensitivity and specificity were 0.82 (95%CI 0.78-0.86) and 0.72 (95%CI 0.66-0.78), respectively. When targeting the gastric corpus, the pooled sensitivity and specificity were 0.92 (95%CI 0.90-0.94) and 0.86 (95%CI 0.82-0.88), respectively. The pooled sensitivity and specificity using magnifying white light endoscopy were 0.90 (95%CI 0.87-0.91) and 0.81 (95%CI 0.77-0.84), respectively. The pooled sensitivity and specificity using magnifying chromoendoscopy were 0.87 (95%CI 0.83-0.91) and 0.85 (95%CI 0.80-0.88), respectively. The "pit plus vascular pattern" classification in the gastric corpus observed by magnifying endoscopy was able to accurately predict the status of H. pylori infection, as indicated by a pooled sensitivity and specificity of 0.96 (95%CI 0.94-0.97) and 0.91 (95%CI 0.87-0.93), respectively, with an AUC of 0.9872.
  
  
  CONCLUSIONS
  Magnifying endoscopy was able to accurately predict the status of H. pylori infection, either in magnifying white light endoscopy or magnifying chromoendoscopy mode. The "pit plus vascular pattern" classification in the gastric corpus is an optimum diagnostic criterion.
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Qi
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Chuanguo
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ji
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Zuo
authors.affiliation: Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Li
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D016481:Helicobacter Infections / Q000000981:diagnostic imaging* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods; D012372:ROC Curve