Abstract
Background: Helicobacter pylori (H. pylori) is the most common
cause of gastric cancer. Growing evidence suggests that the regular
arrangement of collecting venules (RAC) can be used as an endoscopic
marker to diagnose H. pylori infection. However, data on the diagnostic
accuracy of RAC for H. pylori infection are conflicting. We performed a
systematic review and meta-analysis of relevant studies to determine the
diagnostic accuracy and clinical utility of RAC for the diagnosis of H.
pylori infection.
Methods: We systematically searched PubMed, Embase, Web of
Science, and the Cochrane Library between inception and Oct 29, 2020,
for studies that assessed the diagnostic accuracy of RAC for H. pylori
infection.
Results: The literature search yielded 2921 nonduplicated
screened titles, of which 58 underwent full-text review. Fifteen
studies, representing a total of 6621 patients, met the inclusion
criteria. The area under the summary receiver operating characteristic
curve was 0.98 (95% CI 0.96 to 0.99). The pooled estimates for RAC were
0.98 (95% CI 0.95 to 0.99) for sensitivity and 0.75 (95% CI 0.54 to
0.88) for specificity. The pooled positive likelihood ratio (PLR) and
negative likelihood ratio (NLR) were 3.8 (95% CI 1.9 to 7.7) and 0.03
(95% CI 0.02 to 0.07), respectively.
Conclusions: RAC can be used as an endoscopic marker for
exclusion of H. pylori infection. However, it cannot be recommended as a
single indicator for the confirmation of H. pylori infection. The
conclusion of this study should be treated with caution because
significant heterogeneity exists between the evaluated studies.
KEYWORDS: regular arrangement of collecting venules, endoscopic
marker, Helicobacter pylori