Ang Tiing Leong, Pittayanon Rapat, Lau James Yun Wong, Rerknimitr Rungsun, Ho Shiaw Hooi, Singh Rajvinder, Kwek Andrew Boon Eu, Ang Daphne Shih Wen, Chiu Philip Wai Yan, Luk Sally, Goh Khean Lee, Ong Jeannie Peng Lan, Tan Jessica Yi-Lyn, Teo Eng Kiong, Fock Kwong Ming
aDepartment of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore bDivision of Gastroenterology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand cDepartment of Surgery, Chinese University of Hong Kong, Hong Kong, China dDepartment of Medicine, University of Malaya, Kuala Lumpur, Malaysia eDepartment of Gastroenterology, Lyell McEwin Hospital, Adelaide, Australia.
Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1473-8. doi: 10.1097/MEG.0000000000000478.
Narrow band imaging (NBI) is generally considered to be useful for lesion characterization, but not enhanced detection of gastric lesions, because of the dark endoscopic view. We tested whether the new generation of NBI (190-NBI or 290-NBI), which is twice as bright as the previous version, would improve detection of premalignant gastric lesions compared with high-definition white light endoscopy (HD-WLE).
This was a multicenter prospective randomized study involving five tertiary institutions in the Asia-Pacific region. A total of 579 patients aged older than 50 years who underwent diagnostic upper gastrointestinal endoscopy were randomized to either HD-WLE or NBI. The outcome measurements were detection of intestinal metaplasia (IM), focal gastric lesions, and gastric cancers.
Focal gastric lesions were detected in 83/286 (29%) and 119/293 patients (40.6%) by HD-WLE and by NBI, respectively (P=0.003). IM was detected in 22/286 patients (7.7%) by HD-WLE and in 52/293 patients (17.7%) by NBI (P<0.001). Gastric cancer were found in 7/286 (2.4%) and 3/293 patients (1%) in HD-WLE and NBI groups, respectively (P=0.189).
NBI increased the detection rate of IM compared with HD-WLE.
窄带成像（NBI）通常被认为有助于病变特征的识别，但由于内镜视野较暗，对胃病变的检测增强效果不佳。我们测试了新一代NBI（190-NBI或290-NBI），其亮度是上一版本的两倍，与高清白光内镜检查（HD-WLE）相比，是否能提高对胃前期病变的检测率。
这是一项多中心前瞻性随机研究，涉及亚太地区的五家三级医疗机构。共有579名年龄超过50岁且接受诊断性上消化道内镜检查的患者被随机分为HD-WLE组或NBI组。观察指标为肠化生（IM）、局灶性胃病变和胃癌的检测情况。
HD-WLE组和NBI组分别在83/286例（29%）和119/293例（40.6%）患者中检测到局灶性胃病变（P = 0.003）。HD-WLE组和NBI组分别在22/286例（7.7%）和52/293例（17.7%）患者中检测到IM（P < 0.001）。HD-WLE组和NBI组分别在7/286例（2.4%）和3/293例（1%）患者中发现胃癌（P = 0.189）。
与HD-WLE相比，NBI提高了IM的检测率。
