Open AccessRegular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta‐analysis
Author(s) -
Yu Fan,
Qin Shaoyou,
Wang Song,
Wang Jiangbin
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14548
Subject(s) - medicine , meta analysis , helicobacter pylori , inclusion and exclusion criteria , cochrane library , helicobacter pylori infection , gastroenterology , likelihood ratios in diagnostic testing , receiver operating characteristic , diagnostic accuracy , publication bias , cancer , pathology , alternative medicine
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 non‐duplicated 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 0.96‐0.99). The pooled estimates for RAC were 0.98 (95% CI 0.95‐0.99) for sensitivity and 0.75 (95% CI 0.54‐0.88) for specificity. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 3.8 (95% CI 1.9‐7.7) and 0.03 (95% CI 0.02‐0.07), 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.