<div><p>Background</p><p>Diagnosis of <i>Helicobacter pylori</i> (<i>H</i>. <i>pylori</i>) infection using magnifying endoscopy offers advantages over conventional invasive and noninvasive tests.</p><p>Objective</p><p>This meta-analysis aimed to assess the diagnostic performance of magnifying endoscopy in the prediction of <i>H</i>. <i>pylori</i> infection.</p><p>Methods</p><p>A literature search of the PubMed, Medline, EMBASE, Science Direct and the Cochrane Library databases was performed. A random-effects model was used to calculate the diagnostic efficiency of magnifying endoscopy for <i>H</i>. <i>pylori</i> infection. A summary receiver operator characteristic curve was plotted, and the area under the curve (AUC) was calculated.</p><p>Results</p><p>A total of 18 studies involving 1897 patients were included. The pooled sensitivity and specificity of magnifying endoscopy to predict <i>H</i>. <i>pylori</i> infection were 0.89 [95% confidence interval (CI) 0.87–0.91] and 0.82 (95%CI 0.79–0.85), respectively, with an AUC of 0.9461. When targeting the gastric antrum, the pooled sensitivity and specificity were 0.82 (95%CI 0.78–0.86) and 0.72 (95%CI 0.66–0.78), respectively. When targeting the gastric corpus, the pooled sensitivity and specificity were 0.92 (95%CI 0.90–0.94) and 0.86 (95%CI 0.82–0.88), respectively. The pooled sensitivity and specificity using magnifying white light endoscopy were 0.90 (95%CI 0.87–0.91) and 0.81 (95%CI 0.77–0.84), respectively. The pooled sensitivity and specificity using magnifying chromoendoscopy were 0.87 (95%CI 0.83–0.91) and 0.85 (95%CI 0.80–0.88), respectively. The “pit plus vascular pattern” classification in the gastric corpus observed by magnifying endoscopy was able to accurately predict the status of <i>H</i>. <i>pylori</i> infection, as indicated by a pooled sensitivity and specificity of 0.96 (95%CI 0.94–0.97) and 0.91 (95%CI 0.87–0.93), respectively, with an AUC of 0.9872.</p><p>Conclusions</p><p>Magnifying endoscopy was able to accurately predict the status of <i>H</i>. <i>pylori</i> infection, either in magnifying white light endoscopy or magnifying chromoendoscopy mode. The “pit plus vascular pattern” classification in the gastric corpus is an optimum diagnostic criterion.</p></div
