title: Magnifying endoscopy with narrow-band imaging may improve diagnostic accuracy of differentiated gastric intraepithelial neoplasia: a feasibility study.
abstract: BACKGROUND
  Magnifying narrow-band imaging has enabled observation of the mucosal and vascular patterns of gastrointestinal lesions. This study investigated the potential value of magnifying endoscopy with narrow-band imaging for the classification of gastric intraepithelial neoplasia.
  
  
  METHODS
  Seventy-six patients with gastric intraepithelial neoplasia (82 lesions) at People's Liberation Army General Hospital from December 2009 to November 2010 were analyzed. All patients underwent magnifying endoscopy with narrow-band imaging, and their lesions were differentiated into probable low-grade intraepithelial neoplasia or possible high-grade intraepithelial neoplasia on the basis of the imaging features. Pathologic proof was subsequently obtained by endoscopic submucosal dissection in every case. The validity of magnifying endoscopy with narrow-band imaging was calculated, considering histopathology to be the gold standard.
  
  
  RESULTS
  Magnifying endoscopy with narrow-band imaging showed 22 low-grade intraepithelial neoplastic lesions and 60 high-grade intraepithelial neoplastic lesions. Of the 22 low-grade intraepithelial neoplastic lesions, 16 showed the same results on both imaging and pathology. Of the 60 high-grade intraepithelial neoplastic lesions, 53 showed the same results on both imaging and pathology. Thus, the sensitivity of magnifying endoscopy with narrow-band imaging for high-grade intraepithelial neoplasia was 89.83%, which was higher than that for low-grade intraepithelial neoplasia (69.57%). However, the specificity for high-grade intraepithelial neoplasia (69.57%) was lower than that for low-grade intraepithelial neoplasia (89.83%). The overall accuracy of magnifying endoscopy with narrow-band imaging was 84.15%.
  
  
  CONCLUSIONS
  Magnifying endoscopy with narrow-band imaging can distinguish between gastric low- and high-grade intraepithelial neoplasia. It may be a convenient and effective method for the classification of gastric intraepithelial neoplasia.
authors.affiliation: Department of Gastroenterology, People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Shu-fang
authors.initials: SF
authors.lastname: Wang
authors.forename: Yun-sheng
authors.initials: YS
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.forename: Zhong-sheng
authors.initials: ZS
authors.lastname: Lu
authors.forename: Xiu-li
authors.initials: XL
authors.lastname: Zhang
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
authors.forename: Li-hua
authors.initials: LH
authors.lastname: Peng
authors.forename: En-qiang
authors.initials: EQ
authors.lastname: Ling-hu
authors.forename: Jiang-yun
authors.initials: JY
authors.lastname: Meng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000175:diagnosis*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis*