title: Light blue crest and ridge/villous patterns in the uninvolved gastric antrum by magnifying NBI endoscopy correlate with serum pepsinogen and gastric cancer occurrence.
abstract: OBJECTIVE
  Combining the magnifying endoscopy and the narrow-band imaging (NBI) system is an endoscopic imaging technique for the enhanced visualization of mucosal microscopic structure and capillaries of the superficial mucosal layer. Light blue crest (LBC) and, ridge/villous pattern have been thought to be suggestive signs for gastric intestinal metaplasia (IM) of magnifying NBI endoscopy. Since the IM is related to gastric cancer risk (GC), the prevalence of LBC and ridge/villous pattern in the nonneoplastic gastric antrum was examined in relation to gastric cancer (GC) risk and serological severity of gastritis.
  
  
  METHODS
  In 100 subjects including 13 GC patients, gastric mucosal pattern were examined using magnifying NBI. The mucosal patterns in the antrum were classified according to the presence of LBC or ridge/villous pattern. Serum pepsinogen (PG) levels were also examined.
  
  
  RESULTS
  The sensitivity and specificity for predicting IM was the best when LBC and ridge/villous patterns were combined (sensitivity 95.2%, specificity 98.7%). Both LBC and ridge/villous pattern showed lower serum PGI and PGI/II ratio than those without (P = 0.046, 0.0005, respectively.) In particular, PGI/II ratio was lowest in ridge/villous pattern. The LBC and ridge/villous pattern showed higher incidence of all GC and diffuse GC compared to those without (P = 0.002, 0.002, respectively).
  
  
  CONCLUSIONS
  LBC and ridge/villous pattern in uninvolved gastric antrum by magnifying NBI endoscopy are useful signs for predicting gastric atrophy in the entire stomach and GC risk.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Okubo
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tahara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shibata
authors.forename: Joh
authors.initials: J
authors.lastname: Yonemura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshioka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kamiya
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tomiyasu
authors.initials: T
authors.lastname: Arisawaz
authors.forename: Naoki
authors.initials: N
authors.lastname: Ohmiya
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D013270:Stomach / Q000473:pathology* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D020116:Pepsinogen A