Does Conventional Narrow-Band Imaging-Guided Biopsy Increase Helicobacter Pylori Detection in Day-to-Day Practice?

Conventional narrow-band imaging-guided site-specific biopsy enhances mucosal visualization in the evaluation of Helicobacter pylori, but its concordance with conventional white light endoscopy remains unclear. This study aims to compare the positivity yield and concordance between conventional white-light endoscopy and conventional narrow-band imaging for detecting Helicobacter pylori in patients with dyspepsia using the rapid urease test.

This observational study included 185 adults with dyspeptic symptoms. Gastric biopsies were obtained using white light endoscopy and conventional narrow band imaging, and all specimens were tested for Helicobacter pylori using the rapid urease test.

The conventional rapid urease test was positive in 175 patients, and the conventional narrow-band imaging rapid urease test was positive in 172 patients, demonstrating a significant association between the two diagnostic approaches. Helicobacter pylori was detected in conventional narrow-band imaging types 1, 2, 3, and 4 in 80%, 93.3%, 97.1%, and 91.4% of cases, respectively; type 5 was absent. No statistically significant association was found between conventional narrow band imaging mucosal patterns and the rapid urease test (P<0.001).

Conventional narrow-band imaging-guided biopsy showed positivity yields that were concordant with those of conventional white-light endoscopy-guided biopsy in identifying Helicobacter pylori using the rapid urease test. No statistically significant difference in the rapid urease test positivity was observed between the two methods in this study population.