Aims:
NISO Biomed EndoFaster is a new device that within 15 seconds measures the gastric pH of the gastric juice through its aspiration from the gastric cavity during routine endoscopy. The aim of this study was to compare the diagnostic accuracy of NISO Biomed EndoFaster in comparison of histological examination as gold standard for chronic atrophic gastritis using narrow band imaging (NBI) targeted biopsies.
Methods:
Prospective study conducted on consecutive adult outpatients undergoing gastroscopy for suspected chronic atrophic gastritis (anemia, dyspepsia). At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster in real time (15 seconds). Endoscopists were blinded to the report of the device. Then patients were evaluated by high resolution narrow band imaging (HR-NBI) after the use of white light (WL). Biopsies were taken where the endoscopists recognized intestinal metaplasia (targeted biopsies) or using Sydney System if intestinal metaplasia was not recognized.
Results:
Overall, 101 patients were included (62% F; 55 (19 – 80) years). Chronic atrophic gastritis was present in 42% of patients. Endofaster showed an accuracy for atrophic gastritis of 87.2% and a sensitivity, specificity, PPV and NPV of 77.8%, 96.4%, 94.6% and 84.4%, respectively, for the diagnosis of hypochloridia. NBI had an accuracy of 90.7% for the diagnosis of intestinal metaplasia. Endofaster allowed to correctly diagnose atrophic gastritis in 3.0% of patients negative to NBI (atrophic gastritis without intestinal metaplasia).
Conclusions:
Endofaster seems a promising tool to correctly diagnose chronic atrophic gastritis. The high PPV suggests performing biopsies only in patients with a real need of doing biopsies. Endoscopy centers where the use of NBI is not available or where NBI does not evidentiate intestinal metaplasia, the use of Endofaster should be considered.
