Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia

BMC Gastroenterology

Jeong Heo¹  Dong Uk Kim¹  Dong Yup Ryu¹  Hyun Young Woo¹  Bong Eun Lee¹  Na Ri Shin²  Do Youn Park²  Gwang Ha Kim¹  Geun Am Song¹  Jin Kwang An¹ 

[1] Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, 1-10, Ami-dong, Seo-gu, Busan, 602-739, Korea;Department of Pathology, Pusan National University School of Medicine, Busan, Korea

关键词: Intestinal metaplasia;    Magnifying endoscopy;    Stomach;   

Others  :  858284
DOI  :  10.1186/1471-230X-12-169

 received in 2012-04-27, accepted in 2012-11-15,  发布年份 2012

【 摘 要 】

Background

Gastric intestinal metaplasia (IM) usually appears in flat mucosa and shows few morphologic changes, making diagnosis using conventional endoscopy unreliable. Magnifying narrow-band imaging (NBI) endoscopy enables evaluation of detailed morphological features that correspond with the underlying histology. The aim of this study was to investigate and clarify the diagnostic efficacy of magnifying NBI endoscopic findings for the prediction and diagnosis of IM.

Methods

Forty-seven patients were prospectively enrolled, and magnifying NBI examinations were performed in the lesser curvature of the midbody and the greater curvature of the upper body. The marginal turbid band (MTB) was defined as an enclosing white turbid band on the epithelial surface/gyri; light blue crest (LBC), as a fine, blue-white line on the crest of the epithelial surface/gyri. Immediately after observation under magnifying endoscopy, biopsy specimens were obtained from the evaluated areas.

Results

The degree of IM significantly increased with increasing MTB/LBC positivity (MTB^-/LBC^-, 0.00 ± 0.00;MTB⁺/LBC^-, 0.44 ± 0.51; MTB⁺/LBC⁺, 0.94 ± 0.24; p < 0.001). Moderate-to-severe IM was more common in MTB⁺/LBC⁺ areas than in MTB⁺/LBC^- areas (p < 0.001). For the diagnosis of IM, MTB had a sensitivity, specificity, and accuracy of 100%, 66.0%, and 81.7%, respectively, and the corresponding values for LBC were 72.1%, 96.0%, and 84.9%.

Conclusion

MTB and LBC observed in the gastric mucosa with magnifying NBI endoscopy are highly accurate indicators of the presence of IM. MTB likely represents a sign of early gastric IM, while LBC appears with progression to severe IM.

【 授权许可】

   
2012 An et al.; licensee BioMed Central Ltd.

【 图 表 】

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