Kurtcehajic Admir, Zerem Enver, Bokun Tomislav, Alibegovic Ervin, Kunosic Suad, Hujdurovic Ahmed, Tursunovic Amir, Ljuca Kenana
Department of Gastroenterology and Hepatology, Blue Medical Group, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina.
Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo 71000, Bosnia and Herzegovina.
World J Gastrointest Endosc. 2024 Mar 16;16(3):157-167. doi: 10.4253/wjge.v16.i3.157.
Conventional magnifying endoscopy with narrow-band imaging (NBI) observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules, subepithelial capillary network, and gastric pits.
To evaluate the effectiveness of a new one-dual (near) focus, NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.
During 2021 and 2022, 68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid (AA). The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa. At the time of the endoscopy, the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy (WLE), near focus (NF), NF-NBI, AA-NF, and AA-NF-NBI modes.
The WLE, NF and NF-NBI endoscopic modes for all patients (204 images) were classified in the same order into three groups. Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order. According to all three observers who completed the work independently, NF magnification was significantly superior to WLE ( < 0.01), and the NF-NBI mode was significantly superior to NF magnification ( < 0.01). After applying AA, the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF ( < 0.01). Interobserver kappa values for WLE were 0.609, 0.704, and 0.598, respectively and were 0.600, 0.721, and 0.637, respectively, for NF magnification. For the NF-NBI mode, the values were 0.378, 0.471, and 0.553, respectively. For AA-NF, they were 0.453, 0.603, and 0.480, respectively, and for AA-NF-NBI, they were 0.643, 0.506, and 0.354, respectively.
When investigating gastric mucosa in microscopic detail, NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules, subepithelial capillary network, and gastric pits among the five endoscopic modalities investigated in this study. AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.
采用窄带成像（NBI）的传统放大内镜观察胃体黏膜时，可显示与集合小静脉、上皮下毛细血管网及胃小凹的规则排列相关的主要模式。
评估一种新型单双（近）焦点NBI模式在评估胃体黏膜微观特征方面相较于传统放大模式的有效性。
在2021年至2022年期间，68例患者接受了近端胃肠道内镜检查，使用放大内镜模式，随后应用醋酸（AA）。采用具有双焦点功能的GIF-190HQ系列NBI系统对胃黏膜进行检查。在内镜检查时，使用白光内镜（WLE）、近焦点（NF）、NF-NBI、AA-NF和AA-NF-NBI模式对所有纳入患者的胃体黏膜进行拍照。
所有患者的WLE、NF和NF-NBI内镜模式（共204张图像）按相同顺序分为三组。AA-NF和AA-NF-NBI内镜模式下，每位患者的两张图像按相同顺序分类。根据独立完成工作的三位观察者的评估，NF放大模式显著优于WLE（P<0.01），NF-NBI模式显著优于NF放大模式（P<0.01）。应用AA后，三位观察者确认AA-NF-NBI显著优于AA-NF（P<0.01）。WLE的观察者间kappa值分别为0.609、0.704和0.598，NF放大模式的观察者间kappa值分别为0.600、0.721和0.637。NF-NBI模式的观察者间kappa值分别为0.378、0.471和0.553。AA-NF的观察者间kappa值分别为0.453、0.603和0.480，AA-NF-NBI的观察者间kappa值分别为0.643、0.506和0.354。
在对胃黏膜进行微观详细检查时，在本研究调查的五种内镜模式中，NF-NBI是评估集合小静脉、上皮下毛细血管网和胃小凹规则排列最有效的内镜模式。AA-NF-NBI是分析隐窝开口和中间部分最有效的内镜模式。
