title: Diagnostic yield of the light blue crest sign in gastric intestinal metaplasia: a meta-analysis.
abstract: BACKGROUND
  The diagnostic yield of light blue crest(LBC) sign, which was observed by narrow band imaging with magnification endoscopy(NBI-ME), in detecting gastric intestinal metaplasia(IM) has shown variable results.
  
  
  OBJECTIVE
  We aimed to assess the diagnostic value of LBC under NBI-ME for detecting gastric IM.
  
  
  METHODS
  We performed a literature search of the Medline/PubMed, Embase, Web of Science, Science Direct and the Cochrane Library Databases; and a meta-analysis of pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and SROC area under the curve, using fixed- and random-effects models, for the accuracy of LBC-based IM diagnosis.
  
  
  RESULTS
  We initially included 4 articles, but excluded 1 article to counter significant heterogeneity. When pooled, the remaining 3 articles, which included 247 patients with 721 lesions, showed the following patterns in IM diagnosis: sensitivity: 0.90 (95% confidence interval [CI] 0.86-0.92); specificity: 0.90 (95% CI 0.86-0.93), positive likelihood ratio: 8.98 (95% CI 6.42-12.58), negative likelihood ratio: 0.12 (95% CI 0.09-0.16), and SROC area under the curve: 0.9560.
  
  
  CONCLUSIONS
  As the studies varied by their definitions for positive LBC, endoscopy types, biopsy protocols, race of patient cohort, and physicians' proficiency, some sample sizes were limited so that subgroup analyses could not be performed.
  
  
  CONCLUSIONS
  We concluded that observing LBC under NBI-ME is an accurate and precise means of diagnosing gastric IM.
authors.affiliation: Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
authors.forename: Youwei
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Yang
mesh_terms: D019540:Area Under Curve; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008679:Metaplasia; D011230:Precancerous Conditions / Q000473:pathology*; D012372:ROC Curve; D015203:Reproducibility of Results