Kawai Yusuke, Sugimoto Mitsushige, Hamada Mariko, Iwata Eri, Niikura Ryota, Nagata Naoyoshi, Fukuzawa Masakatsu, Itoi Takao, Kawai Takashi
Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Department of Gastroenterology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
J Clin Biochem Nutr. 2022 May;70(3):290-296. doi: 10.3164/jcbn.21-145. Epub 2022 Feb 1.
In oral endoscopy, linked color imaging (LCI) detects atrophic border and gastric mucosal diseases better than white light imaging (WLI), but its usefulness in transnasal endoscopy has not been fully investigated. Here, we retrospectively compared WLI and LCI using the Lab* color space in images from 57 patients aged ≥20 years who had undergone transnasal endoscopy as part of a health check-up from May 2016 to January 2017. We measured color differences at the atrophic/non-atrophic and fundic/pyloric mucosal borders. Gastritis severity scored using the Kyoto classification of gastritis was similar between the two techniques. However, in patients with current and with past infection, color difference at the atrophic border was greater with LCI (21.58 ± 6.97 and 27.34 ± 10.32, respectively) than with WLI [14.42 ± 5.95 ( = 0.004) and 17.9 ± 8.48 (<0.001)]; in those never infected with , color difference at the fundic/pyloric mucosal border was greater with LCI than with WLI (<0.001). Because of its enhancement of atrophic border detection, we recommend linked color imaging as the method of choice for transnasal endoscopy in health check-ups, particularly for identifying people at high risk of gastric cancer.
在口腔内镜检查中，与白光成像（WLI）相比，联动成像（LCI）能更好地检测萎缩边界和胃黏膜疾病，但它在鼻内镜检查中的应用价值尚未得到充分研究。在此，我们回顾性比较了2016年5月至2017年1月期间作为健康检查一部分接受鼻内镜检查的57例年龄≥20岁患者图像中使用Lab*颜色空间的WLI和LCI。我们测量了萎缩/非萎缩和胃底/幽门黏膜边界处的颜色差异。两种技术使用胃炎京都分类法评分的胃炎严重程度相似。然而，在现感染和既往感染患者中，LCI在萎缩边界处的颜色差异（分别为21.58±6.97和27.34±10.32）大于WLI[14.42±5.95（P = 0.004）和17.9±8.48（P<0.001）]；在从未感染过幽门螺杆菌的患者中，LCI在胃底/幽门黏膜边界处的颜色差异大于WLI（P<0.001）。由于其增强了萎缩边界检测，我们建议在健康检查中联动成像作为鼻内镜检查的首选方法，特别是用于识别胃癌高危人群。
