Background. EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis. Aims. To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies. Methods. Prospective study on consecutive adult patients undergoing gastroscopy between April and November 2018. Patients in therapy with proton pump inhibitors, previous gastric surgery, and/or known gastric neoplasia were excluded. At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster® in 15 seconds. Endoscopists were blinded to the report of EndoFaster®. Evaluation of gastric mucosa in HR-white light was firstly performed, then with HR-NBI allowing to perform targeted biopsies on areas suspected for intestinal metaplasia; otherwise, biopsies were performed according to the updated Sydney System protocol and sent for histopathological evaluation. Results. Overall, 124 patients were included [64% F; 56 (18-85) years]. Corpus atrophic gastritis was present in 41.9% of patients. EndoFaster® showed an accuracy for corpus atrophic gastritis diagnosis, compared to histopathological evaluation as gold standard, of 87.1% and a sensitivity, specificity, PPV, and NPV of 78.8%, 93.1%, 89.1%, and 85.9%, respectively. pH showed a positive correlation with the severity score of atrophy (, 95% CI: 0.73-0.81, and ). EndoFaster® allowed to diagnose corpus atrophic gastritis in 3.7% of patients negative to NBI (corpus atrophic gastritis without intestinal metaplasia). Conclusion. EndoFaster® seems a promising tool to diagnose corpus atrophic gastritis. The evaluation of hypo-achlorhydria during gastroscopy can address bioptic sampling in corpus atrophic gastritis patients without intestinal metaplasia.

中文翻译：

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EndoFaster® 和窄带成像内窥镜检查对胃酸分泌受损患者的诊断准确性：一项实时前瞻性研究

背景。EndoFaster® 在胃镜检查过程中实时分析胃液，从而检测出胃酸不足的情况，如体萎缩性胃炎。窄带成像 (NBI) 内窥镜检查可以准确检测和执行肠化生区域的目标活检，这是一种通常与胃体萎缩性胃炎相关的组织学变化。目标。通过高分辨率 (HR) NBI 靶向活检比较 EndoFaster® 与组织学评估对胃体萎缩性胃炎的诊断准确性。方法. 对 2018 年 4 月至 2018 年 11 月期间连续接受胃镜检查的成年患者进行的前瞻性研究。排除了接受质子泵抑制剂治疗、既往胃手术史和/或已知胃肿瘤形成的患者。在胃镜检查开始时，15 秒内吸出胃液并通过 EndoFaster® 进行分析。内镜医师对 EndoFaster® 的报告不知情。首先在 HR-白光下对胃黏膜进行评估，然后使用 HR-NBI 对疑似肠化生的区域进行靶向活检；否则，根据更新的悉尼系统方案进行活检并送去进行组织病理学评估。结果. 总体而言，包括 124 名患者 [64% F; 56（18-85）岁]。41.9%的患者出现胃体萎缩性胃炎。与作为金标准的组织病理学评估相比，EndoFaster® 的诊断准确性为 87.1%，敏感性、特异性、PPV 和 NPV 分别为 78.8%、93.1%、89.1% 和 85.9%。pH与萎缩严重程度评分呈正相关（, 95% CI: 0.73-0.81, 和）。EndoFaster® 允许在 3.7% 的 NBI 阴性患者中诊断出胃体萎缩性胃炎（无肠化生的胃体萎缩性胃炎）。结论。EndoFaster® 似乎是诊断胃体萎缩性胃炎的有前途的工具。胃镜检查中胃酸过少的评估可以解决无肠化生的萎缩性胃炎患者的活检取样问题。