Classification of histological severity of Helicobacter pylori-associated gastritis by confocal laser endomicroscopy

Table 1 Characteristics of patients enrolled in this study

Patients	118
Gender
Female	44
Male	74
Age (yr), median (range)	49.8 (19-67)
H. pylori infection (mCGS, mean ± SD)
Positive	41
+	15 (1.11 ± 0.53)
++	15 (1.68 ± 0.51)
+++	11 (2.42 ± 0.45)
Negative	77 (0.61 ± 0.39)
Indication for CLE
Upper GI symptoms	87
Screened for gastric cancer	31
Endoscopic diagnosis
Normal stomach	6
Gastritis	92
Peptic ulcer	5
Polyps	13
Early gastric cancer	2

H. pylori: Helicobacter pylori; mCGS: Mean confocal gastritis score; CLE: Confocal laser endomicroscopy; GI: Gastrointestinal.

Table 2 Sensitivity, specificity, positive predictive values and negative predictive values of confocal laser endomicroscopy for the diagnosis of normal mucosa, Helicobacter pylori-associated active inflammation, glandular atrophy and intestinal metaplasia (per specimen) [% (95% CI)]

CLE classification	Sensitivity	Specificity	PPV	NPV
Normal mucosa	94.6 (91.9-97.4)	97.4 (95.8-99.1)	96.5 (94.2-98.7)	96.1 (94.1-98.1)
Active inflammation	98.5 (97.2-99.8)	94.6 (91.9-97.4)	95.9 (93.7-97.9)	98.0 (96.3-99.7)
Glandular atrophy	92.9 (87.0-98.9)	95.2 (93.3-97.0)	72.5 (63.4-81.7)	98.9 (98.1-99.9)
Intestinal metaplasia	98.6 (95.7-100.0)	100 (100.0-100.0)	100 (100.0-100.0)	99.8 (99.4-100.0)

CLE: Confocal laser endomicroscopy; PPV: Positive predictive value; NPV: Negative predictive value.

Table 3 Confocal laser endomicroscopy and white-light endoscopy in predicting histological changes

Biopsy sites	CLE normal sites1	CLE abnormal sites1
		Inflammation	Atrophy	IM	Early cancer
WLE normal sites	216	173	41	45	0
WLE abnormal sites2	31	83	25	23	2

¹The normal and abnormal sites on confocal laser endomicroscopy (CLE) images were confirmed by histology;

²Abnormal sites include erythema, erosion, nodules and petechiae, etc., with no noticeable lesions such as ulcers or polyps on white light endoscopy (WLE) images. IM: Intestinal metaplasia.