Dutta Amit Kumar, Sajith Kattiparambil Gangadharan, Pulimood Anna Benjamin, Chacko Ashok
Department of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Indian J Gastroenterol. 2013 Jan;32(1):37-42. doi: 10.1007/s12664-012-0246-5. Epub 2012 Sep 16.
Narrow band imaging (NBI) detects mucosal surface details (pit pattern) as well as the microvasculature pattern of mucosa. In premalignant conditions the pattern and regularity of pits and microvasculature are altered. We aimed to assess whether NBI is superior to conventional white light gastroscopy (WLG) in detecting potentially premalignant gastric lesions.
We conducted a randomized prospective crossover study from January 2009 to July 2009. Patients above 45 years of age with dyspepsia in absence of alarm symptoms underwent gastric mucosal examination using WLG and NBI in the same session by different endoscopists who were blinded to each other's endoscopy findings. Biopsy was taken if required at the end of the second gastroscopy after a third observer reviewed reports of both scopists. The yield of gastric potentially premalignant lesions (atrophic gastritis, intestinal metaplasia, dysplasia, adenomatous polyp) was compared for both procedures.
Two hundred [mean age 52.3 (6.4) years, males-66 %] patients participated in the study. Thirty-two patients were diagnosed to have potentially premalignant lesions using both modalities. No patient had early gastric cancer. WLG detected lesions in 17 patients (atrophic gastritis in 12, atrophic gastritis with intestinal metaplasia in 5) and NBI in 31 patients (atrophic gastritis in 22, atrophic gastritis with intestinal metaplasia in 9). The sensitivity of lesion detection by NBI was significantly higher than WLG (p = 0.001).
NBI was superior to WLG for detection of atrophic gastritis and intestinal metaplasia.
窄带成像（NBI）可检测黏膜表面细节（腺管开口形态）以及黏膜的微血管形态。在癌前病变状态下，腺管开口和微血管的形态及规则性会发生改变。我们旨在评估NBI在检测潜在癌前胃部病变方面是否优于传统白光胃镜检查（WLG）。
我们于2009年1月至2009年7月进行了一项随机前瞻性交叉研究。年龄在45岁以上且有消化不良症状但无报警症状的患者，在同一次检查中由互不了解对方内镜检查结果的不同内镜医师分别使用WLG和NBI进行胃黏膜检查。在第三位观察者复查两位内镜医师的报告后，于第二次胃镜检查结束时根据需要进行活检。比较两种检查方法对胃潜在癌前病变（萎缩性胃炎、肠化生、异型增生、腺瘤性息肉）的检出率。
200例患者[平均年龄52.3（6.4）岁，男性占66%]参与了研究。两种检查方法均诊断出32例患者有潜在癌前病变。无患者患有早期胃癌。WLG检测出17例病变（12例萎缩性胃炎，5例萎缩性胃炎伴肠化生），NBI检测出31例病变（22例萎缩性胃炎，9例萎缩性胃炎伴肠化生）。NBI检测病变的敏感性显著高于WLG（p = 0.001）。
NBI在检测萎缩性胃炎和肠化生方面优于WLG。
