title: Application of magnifying endoscopy with narrow-band imaging in diagnosing gastric lesions: a prospective study.
abstract: BACKGROUND
  Magnifying endoscopy with narrow-band imaging (ME-NBI) can more clearly assess the surface pattern and microvascular architecture of gastric lesions.
  
  
  OBJECTIVE
  To evaluate the diagnostic efficacy of ME-NBI in patients with early gastric cancer.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Single academic center.
  
  
  METHODS
  This study involved 164 suspected gastric lesions in 146 consecutive patients who underwent ME-NBI for additional differential diagnosis before treatment.
  
  
  METHODS
  ME-NBI findings were classified into 3 groups based on irregularities, absence of surface pattern, and microvascular architecture. All lesions were treated endoscopically or surgically, and ME-NBI diagnosis was compared with histopathological findings.
  
  
  METHODS
  Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time ME-NBI diagnosis were determined.
  
  
  RESULTS
  The sensitivity, specificity, and accuracy of ME-NBI were 97.3%, 84.4%, and 90.2%, respectively, in distinguishing between cancerous and noncancerous lesions and were 92.3%, 89.7%, and 90.4%, respectively, in distinguishing undifferentiated from differentiated adenocarcinoma. ME-NBI accurately predicted depth of invasion in 37 of 39 differentiated adenocarcinomas (95%).
  
  
  CONCLUSIONS
  The sample size was relatively small.
  
  
  CONCLUSIONS
  ME-NBI can successfully distinguish between cancerous and noncancerous lesions and between undifferentiated and differentiated adenocarcinomas. Of the 3 patterns on ME-NBI, type A is mainly characteristic of noncancerous lesions, type B is a good indicator of differentiated adenocarcinoma and intramucosal/superficially invasive cancers, and type C is indicative of undifferentiated adenocarcinoma or differentiated cancer with deep submucosal invasion.
authors.affiliation: Division of Gastroenterology and Hepatology, Shanghai Jiao-Tong University School of Medicine, Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiao-Tong University, Shanghai, China.
authors.forename: H-y
authors.initials: HY
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Dai
authors.forename: H-b
authors.initials: HB
authors.lastname: Xue
authors.forename: Y-j
authors.initials: YJ
authors.lastname: Zhao
authors.forename: X-y
authors.initials: XY
authors.lastname: Chen
authors.forename: Y-j
authors.initials: YJ
authors.lastname: Gao
authors.forename: Y
authors.initials: Y
authors.lastname: Song
authors.forename: Z-z
authors.initials: ZZ
authors.lastname: Ge
authors.forename: X-b
authors.initials: XB
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*