Narrow Band Imaging for the Detection of Gastric Intestinal Metaplasia and Dysplasia During Surveillance Endoscopy

• Published in: Digestive diseases and sciences Vol. 55; no. 12; pp. 3442 - 3448
• Main Authors: Capelle, Lisette G, Haringsma, Jelle, de Vries, Annemarie C, Steyerberg, Ewout W, Biermann, Katharina, van Dekken, Herman, Kuipers, Ernst J
• Format: Journal Article
• Language: English
• Published: Boston Boston : Springer US 01.12.2010; Springer US; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Biochemistry; Biological and medical sciences; Biopsy; Dysplasia; Endoscopy; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroscopy - methods; Hepatology; Humans; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Metaplasia - pathology; Middle Aged; Oncology; Original; Original Article; Other diseases. Semiology; Precancerous Conditions - pathology; Prospective Studies; Stomach - pathology; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Transplant Surgery; Tumors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Dysplasia; Surveillance; White light endoscopy; Intestinal metaplasia; Narrow band imaging; Premalignant lesion; White light; Gastric intestinal metaplasia; Metabolic diseases; Language disorder; Dysphasia; Communication disorder; Narrow band signal; Gastroenterology; Digestive diseases; Endoscopy; Gastric disease
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-010-1189-2

Background Surveillance of premalignant gastric lesions relies mainly on random biopsy sampling. Narrow band imaging (NBI) may enhance the accuracy of endoscopic surveillance of intestinal metaplasia (IM) and dysplasia. We aimed to compare the yield of NBI to white light endoscopy (WLE) in the surveillance of patients with IM and dysplasia. Methods Patients with previously identified gastric IM or dysplasia underwent a surveillance endoscopy. Both WLE and NBI were performed in all patients during a single procedure. The sensitivity of WLE and NBI for the detection of premalignant lesions was calculated by correlating endoscopic findings to histological diagnosis. Results Forty-three patients (28 males and 15 females, mean age 59 years) were included. IM was diagnosed in 27 patients; 20 were detected by NBI and WLE, four solely by NBI and three by random biopsies only. Dysplasia was detected in seven patients by WLE and NBI and in two patients by random biopsies only. Sixty-eight endoscopically detected lesions contained IM: 47 were detected by WLE and NBI, 21 by NBI only. Nine endoscopically detected lesions demonstrated dysplasia: eight were detected by WLE and NBI, one was detected by NBI only. The sensitivity, specificity, positive and negative predictive values for detection of premalignant lesions were 71, 58, 65 and 65% for NBI and 51, 67, 62 and 55% for WLE, respectively. Conclusions NBI increases the diagnostic yield for detection of advanced premalignant gastric lesions compared to routine WLE.