Usefulness of a hemoglobin index determined by electronic endoscopy in the diagnosis of helicobacter pylori gastritis

Background: In patients with Helicobacter pylori infection, gastric endoscopy usually shows diffuse mucosal redness that disappears after successful H. pylori eradication. However, some infected patients do not show such redness. Therefore, disagreement continues concerning the need for gastric endoscopy in suspected H. pylori infection. Methods: Usefulness of a hemoglobin index (IHb) in diagnosis and follow up of H. pylori gastritis was examined endoscopically and histopathologically. Results: Patients with infection showed a higher mean IHb than those without infection (70.0 ± 10.0 vs 54.3 ± 4.7, P < 0.0001). Sensitivity, specificity and accuracy of IHb for diagnosing H. pylori infection based on a cutoff value of 60 was higher than for the endoscopist's evaluation of diffuse redness (sensitivity 95.7 vs 92.6%, specificity 82.4 vs 66.6%, accuracy 93.0 vs 87.2%). Hemoglobin indices also reflected histolosically evident mucosal inflammatory changes more closely than did the endoscopist's evaluation. Hemoglobin indices significantly decreased after H. pylori eradication, as did histologic findings of mucosal congestion and numbers of erythrocytes in foveolae. Both histologic findings correlated positively with hemoglobin indices. Conclusion: The IHb is an objective endoscopic measure of mucosal inflammation that is useful in the diagnosis and follow up of H. pylori gastritis.