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Gastrointest Endosc. 2009 Aug;70(2):246-53. doi: 10.1016/j.gie.2008.11.046. Epub 2009 Apr 21.

Gastric mucosal pattern by using magnifying narrow-band imaging endoscopy clearly distinguishes histological and serological severity of chronic gastritis.

Author information

1
Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan. tomomiccyu@yahoo.co.jp

Abstract

BACKGROUND:

Magnifying narrow-band imaging (NBI) endoscopy clearly visualizes superficial gastric mucosal patterns and capillary patterns.

OBJECTIVE:

To investigate gastric mucosal patterns by using magnifying NBI endoscopy and identify any relationship between those patterns and Helicobacter pylori-induced gastritis.

DESIGN:

Gastric mucosal patterns seen with magnifying NBI in uninvolved gastric corpus were divided into the following categories: normal--small, round pits with regular subepithelial capillary networks; type 1-slightly enlarged, round pits with unclear or irregular subepithelial capillary networks; type 2--obviously enlarged, oval or prolonged pits with increased density of irregular vessels; and type 3-well--demarcated oval or tubulovillous pits with clearly visible coiled or wavy vessels.

SETTING:

Department of Gastroenterology, Fujita Health University.

PATIENTS:

This study involved 106 participants undergoing upper endoscopy.

RESULTS:

H pylori infection-positive ratios of normal and types 1, 2, and 3 patterns were 7.5%, 92.9%, 94.5%, and 66.7%, respectively. Sensitivity and specificity for types 1 + 2 + 3 for detection of H pylori positivity and type 3 for detection of intestinal metaplasia were 95.2%, 82.2%, 73.3%, and 95.6%, respectively. Development of mucosal patterns from normal to types 1, 2, and 3 was correlated with all histological parameters (P < .0001), lower pepsinogen I/II ratios (P < .0001), and degree of endoscopic atrophy (P < .0001). Sensitivity and specificity of type 3 for the prediction of severe histological atrophy was also better than those of serum pepsinogen level and standard endoscopy.

LIMITATIONS:

Only 1 endoscopist performed endoscopic procedures, and interobserver agreement could not be assessed.

CONCLUSIONS:

Magnifying NBI endoscopy is useful for predicting H pylori infection and the histological severity of gastritis and is valuable for predicting gastric atrophy in the entire stomach.

PMID:
19386303
DOI:
10.1016/j.gie.2008.11.046
[Indexed for MEDLINE]

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