Department of Gastroenterology, Hepatology and Infectious Diseases, Magdeburg, Germany,
Department of Gastroenterology, Hepatology and Infectious Diseases, Magdeburg, Germany.
Dig Dis. 2020;38(1):9-14. doi: 10.1159/000501265. Epub 2019 Jul 23.
Blue light imaging (BLI) and linked color imaging (LCI) are new imaging modalities for the endoscopic evaluation of mucosal changes within the digestive tract. There is little experience with these modalities in the characterization of chronic gastritis (CG) intestinal metaplasia (IM) and atrophy in the stomach.
In a single-center observational pilot study, we correlated endoscopic findings with histology in selected patients.
Findings from 29 patients were included in the analysis. Six patients had macroscopically normal gastric mucosa at endoscopy, and this was confirmed histologically in 5 of them. At endoscopy, 15 patients had the presence of IM in the antrum predicted, and this was confirmed histologically in 11 (73%). In the corpus, we predicted the presence of IM in 14 patients, and this was confirmed in 11 (78%) at histology. Eleven patients had the endoscopic suspicion of atrophy in antrum, which was confirmed in 9 patients (82%). In total, 14 patients had endoscopic suspicion of atrophy in corpus mucosa at endoscopy, but only 10 were confirmed in histology (71%). The concordance of endoscopic classification and histology was 93% for antrum and 88% for corpus. The positive predictive value and negative predictive value for IM were 0.74 and 0.83 and for atrophy 0.63 and 0.97, respectively.
LCI and BLI are helpful in characterization of mucosal changes in CG. The ability to rule out premalignant conditions by endoscopy only reflects the clinical use and harbors significant clinical implications.
蓝激光成像(BLI)和联合色彩成像(LCI)是用于评估消化道黏膜变化的新型内镜成像模式。在胃慢性炎症(CG)肠上皮化生(IM)和萎缩的特征方面,这些模式的经验较少。
在一项单中心观察性试点研究中,我们将内镜表现与选定患者的组织学表现相关联。
共纳入 29 例患者的资料进行分析。6 例患者内镜下胃黏膜正常,其中 5 例组织学证实。15 例患者内镜下预测存在胃窦 IM,组织学证实 11 例(73%)。胃体部,我们预测 14 例存在 IM,组织学证实 11 例(78%)。11 例患者内镜下怀疑存在胃窦萎缩,组织学证实 9 例(82%)。共 14 例患者内镜下怀疑胃体黏膜萎缩,但组织学仅证实 10 例(71%)。内镜分类与组织学的一致性在胃窦为 93%,在胃体为 88%。IM 的阳性预测值和阴性预测值分别为 0.74 和 0.83,萎缩分别为 0.63 和 0.97。
LCI 和 BLI 有助于 CG 黏膜变化的特征描述。仅凭内镜排除癌前病变的能力仅反映了临床应用,并具有重要的临床意义。