Saka Akiko, Yagi Kazuyoshi, Nimura Satoshi
Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Dig Endosc. 2015 Nov;27(7):734-41. doi: 10.1111/den.12483. Epub 2015 Jun 8.
As atrophic gastritis and intestinal metaplasia as a result of Helicobacter pylori are considered risk factors for gastric cancer, it is important to assess their severity. In the West, the operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) staging systems based on biopsy have been widely adopted. In Japan, however, narrow-band imaging (NBI)-magnifying endoscopic diagnosis of gastric mucosal inflammation, atrophy, and intestinal metaplasia has been reported to be fairly accurate. Therefore, we investigated the practicality of NBI-magnifying endoscopy (NBI-ME) for gastritis staging.
We enrolled 55 patients, in whom NBI-ME was used to score the lesser curvature of the antrum (antrum) and the lesser curvature of the lower body (corpus). The NBI-ME score classification was established from images obtained beforehand, and then biopsy specimens taken from the observed areas were scored according to histological findings. The NBI-ME and histology scores were then compared. Furthermore, we assessed the NBI-ME and histology stages using a combination of scores for the antrum and corpus, and divided the stages into two risk groups: low and high. The degree to which the stage assessed by NBI-ME approximated that assessed by histology was then ascertained.
Degree of correspondence between the NBI-ME and histology scores was 69.1% for the antrum and 72.7% for the corpus, and that between the high- and low-risk groups was 89.1%.
Staging of gastritis using NBI-ME approximates that based on histology, and would be a practical alternative to the latter.
由于幽门螺杆菌导致的萎缩性胃炎和肠化生被认为是胃癌的危险因素,因此评估其严重程度很重要。在西方,基于活检的胃炎评估手术链接(OLGA)和胃肠化生评估手术链接(OLGIM)分期系统已被广泛采用。然而,在日本,据报道窄带成像(NBI)放大内镜诊断胃黏膜炎症、萎缩和肠化生相当准确。因此,我们研究了NBI放大内镜检查(NBI-ME)用于胃炎分期的实用性。
我们纳入了55例患者,使用NBI-ME对胃窦小弯(胃窦)和胃体小弯(胃体)进行评分。根据预先获得的图像建立NBI-ME评分分类,然后根据组织学结果对从观察区域采集的活检标本进行评分。然后比较NBI-ME评分和组织学评分。此外,我们使用胃窦和胃体的评分组合评估NBI-ME和组织学分期,并将分期分为两个风险组:低风险组和高风险组。然后确定NBI-ME评估的分期与组织学评估的分期的近似程度。
胃窦的NBI-ME评分与组织学评分的对应程度为69.1%,胃体为72.7%,高风险组和低风险组之间的对应程度为89.1%。
使用NBI-ME进行胃炎分期与基于组织学的分期相近,将是后者的一种实用替代方法。