Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 16, 2023; 15(12): 735-744
Published online Dec 16, 2023. doi: 10.4253/wjge.v15.i12.735
Clinical usefulness of linked color imaging in identifying Helicobacter pylori infection: A systematic review and meta-analysis
Yu Zhang, Jing-Zhai Wang, Xuan Bai, Peng-Li Zhang, Qiang Guo
Yu Zhang, Jing-Zhai Wang, Xuan Bai, Peng-Li Zhang, Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
Yu Zhang, Jing-Zhai Wang, Xuan Bai, Peng-Li Zhang, Qiang Guo, Yunnan Digestive Endoscopy Clinical Medical Center, Kunming 650000, Yunnan Province, China
Qiang Guo, Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China
Author contributions: Guo Q brought the idea of this study; Wang JZ, Bai X, and Zhang PL worked together for literature searching and data analysis; Zhang Y wrote the manuscript.
Supported by Clinical Medical Center of Yunnan Provincial Health Commission, No. 2020LCZXKF-XH05 and 2021LCZXXF-XH03; Young Academic Talents Cultivation Program of Yunnan Province, No. 202205AC160070.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Guo, MD, Chief Physician, Department of Gastroenterology, The First People’s Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, No. 157 Jinbi Road, Kunming 650000, Yunnan Province, China. gqkj003@sina.com
Received: August 29, 2023
Peer-review started: August 29, 2023
First decision: October 10, 2023
Revised: October 31, 2023
Accepted: November 24, 2023
Article in press: November 24, 2023
Published online: December 16, 2023
Abstract
BACKGROUND

Accurate diagnosis of Helicobacter pylori (H. pylori) infection status is a crucial premise for eradication therapy, as well as evaluation of risk for gastric cancer. Recent progress on imaging enhancement endoscopy (IEE) made it possible to not only detect precancerous lesions and early gastrointestinal cancers but also to predict H. pylori infection in real time. As a novel IEE modality, linked color imaging (LCI) has exhibited its value on diagnosis of lesions of gastric mucosa through emphasizing minor differences of color tone.

AIM

To compare the efficacy of LCI for H. pylori active infection vs conventional white light imaging (WLI).

METHODS

PubMed, Embase, Embase and Cochrane Library were searched up to the end of April 11, 2022. The random-effects model was adopted to calculate the diagnostic efficacy of LCI and WLI. The calculation of sensitivity, specificity, and likelihood ratios were performed; symmetric receiver operator characteristic (SROC) curves and the areas under the SROC curves were computed. Quality of the included studies was chosen to assess using the quality assessment of diagnostic accuracy studies-2 tool.

RESULTS

Seven original studies were included in this study. The pooled sensitivity, specificity, positive likelihood rate, and negative likelihood rate of LCI for the diagnosis of H. pylori infection of gastric mucosa were 0.85 [95% confidence interval (CI): 0.76-0.92], 0.82 (95%CI: 0.78-0.85), 4.71 (95%CI: 3.7-5.9), and 0.18 (95%CI: 0.10-0.31) respectively, with diagnostic odds ratio = 26 (95%CI: 13-52), SROC = 0.87 (95%CI: 0.84-0.90), which showed superiority of diagnostic efficacy compared to WLI.

CONCLUSION

Our results showed LCI can improve efficacy of diagnosis on H. pylori infection, which represents a useful endoscopic evaluation modality for clinical practice.

Keywords: Helicobacter pylori infection, Endoscopic diagnosis, Linked color imaging, Gastric cancer, Meta-analysis

Core Tip: As a novel imaging enhancement endoscopy modality, linked color imaging (LCI) has exhibited its value on diagnosis of lesions of gastric mucosa through emphasizing minor differences of color tone. In this meta-analysis enrolled seven clinical trials, we showed LCI can improve efficacy of diagnosis on Helicobacter pylori infection compared with white light endoscopy, which represents a useful endoscopic evaluation modality for clinical practice.