title: Investigation of relationships among gastroesophageal reflux disease subtypes using narrow band imaging magnifying endoscopy.
abstract: OBJECTIVE
  To investigate the relationships among subtypes of gastroesophageal reflux disease (GERD) using narrow band imaging (NBI) magnifying endoscopy.
  
  
  METHODS
  A reflux disease questionnaire was used to screen 120 patients representing the three subtypes of GERD (n = 40 for each subtypes): nonerosive reflux disease (NERD), reflux esophagitis (RE) and Barrett's esophagus (BE). NBI magnifying endoscopic procedure was performed on the patients as well as on 40 healthy controls. The demographic and clinical characteristics, and NBI magnifying endoscopic features, were recorded and compared among the groups. Targeted biopsy and histopathological examination were conducted if there were any abnormalities. SPSS 18.0 software was used for all statistical analysis.
  
  
  RESULTS
  Compared with healthy controls, a significantly higher proportion of GERD patients had increased number of intrapapillary capillary loops (IPCLs) (78.3% vs 20%, P < 0.05), presence of microerosions (41.7% vs 0%, P < 0.05), and a non-round pit pattern below the squamocolumnar junction (88.3% vs 30%, P < 0.05). The maximum (228 ± 4.8 vs 144 ± 4.7, P < 0.05), minimum (171 ± 3.8 vs 103 ± 4.4, P < 0.05), and average (199 ± 3.9 vs 119 ± 3.9, P < 0.05) numbers of IPCLs/field were also significantly greater in GERD patients. However, comparison among groups of the three subtypes showed no significant differences or any linear trend, except that microerosions were present in 60% of the RE patients, but in only 35% and 30% of the NERD and BE patients, respectively (P < 0.05).
  
  
  CONCLUSIONS
  Patients with GERD, irrespective of subtype, have similar micro changes in the distal esophagus. The three forms of the disease are probably independent of each other.
authors.affiliation: Jing Lv, Dong Liu, Shi-Yang Ma, Jun Zhang, Department of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710004, Shaanxi Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lv
authors.affiliation: Jing Lv, Dong Liu, Shi-Yang Ma, Jun Zhang, Department of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710004, Shaanxi Province, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Jing Lv, Dong Liu, Shi-Yang Ma, Jun Zhang, Department of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710004, Shaanxi Province, China.
authors.forename: Shi-Yang
authors.initials: SY
authors.lastname: Ma
authors.affiliation: Jing Lv, Dong Liu, Shi-Yang Ma, Jun Zhang, Department of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710004, Shaanxi Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D001471:Barrett Esophagus / Q000145:classification / Q000473:pathology*; D001706:Biopsy; D016022:Case-Control Studies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004942:Esophagitis, Peptic / Q000145:classification / Q000473:pathology*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000145:classification / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires
keywords: Gastroesophageal reflux; Gastroesophageal reflux disease; Intrapapillary capillary loops; Magnifying endoscopy; Narrow band imaging