Evaluating the diagnoses of gastric antral lesions using magnifying endoscopy with narrow-band imaging in a Chinese population.
OBJECTIVE
To evaluate the accuracy of diagnosing gastric antral lesions in routine clinical practice using magnifying endoscopy with narrow-band imaging (M-NBI) as a real-time diagnosing technique.


METHODS
Consecutive patients undergoing upper endoscopy were selected for the study. In each patient, the mucosa of the gastric antrum was observed by M-NBI, and the gastric microstructure was categorized into five types (A-E). Based on these patterns, histological types were predicted in a real-time manner. The accuracy of these predictions was evaluated based on histological findings. Inter-observer agreement was also assessed.


RESULTS
A total of 207 sites in 90 patients were examined by M-NBI. Compared with type A gastric microstructure, types B and C gastric microstructure showed a significantly higher degree of inflammation (P < 0.001). The sensitivity, specificity and accuracy of types B + C microstructure as a predictor of gastric inflammation were 85.4, 81.7 and 83.1 %, respectively. Similarly, the sensitivity, specificity and accuracy of type D microstructure as a predictor of gastric intestinal metaplasia were 71.8, 95.2 and 90.8 %, respectively, and those of type E microstructure as a predictor of early gastric cancer were 80.0, 98.9 and 97.6 %, respectively. The sensitivity and specificity of type B alone, type C alone and types B + C combined for the detection of Helicobacter pylori infection were 52.2 and 87.0 %, 22.8 and 92.2 %, 75.0 and 79.1 %, respectively. The kappa value for the inter-observer agreement was 0.715 (95 % confidence interval 0.655-0.895).


CONCLUSIONS
In conclusion, M-NBI can significantly improve the accuracy of the prediction of histopathology of gastric antral lesions in vivo, implying the possibility of using M-NBI as an effective diagnosis technique.
Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Beijing, 100038, China, liuhong1118@126.com.
Hong
H
Liu
Jing
J
Wu
Xiang-Chun
XC
Lin
Nan
N
Wei
Wu
W
Lin
Hong
H
Chang
Xue-Mei
XM
Du
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology / Q000648:ultrastructure*; D005756:Gastritis / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D015588:Observer Variation; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology / Q000648:ultrastructure*; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013274:Stomach Neoplasms / Q000208:ethnology / Q000382:microbiology / Q000473:pathology / Q000648:ultrastructure*