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CC BY-NC-ND 4.0 · Endoscopy 2022; 10(04): E441-E447
DOI: 10.1055/a-1759-2568
Original article

Usefulness of optical enhancement endoscopy combined with magnification to improve detection of intestinal metaplasia in the stomach

Sergio Sobrino-Cossío
 1   Hospital Ángeles del Pedregal, Ciudad de Mexico, Mexico
 2   Gástrica, Centro Avanzado en Endoscopia y Estudios Funcionales, Mexico City, Mexico
,
Oscar Teramoto-Matsubara
 2   Gástrica, Centro Avanzado en Endoscopia y Estudios Funcionales, Mexico City, Mexico
 3   Hospital ABC Ciudad de Mexico, Mexico
,
Fabian Emura
 4   Endoscopia Gastrointestinal Avanzada, EmuraCenter Latinoamérica y Departamento de Gastroenterología de la Universidad de la Sabana, Bogotá, Colombia
 5   Departamento de Gastroenterología de la Universidad de la Sabana, Chia, Cundinamarca, Colombia
,
Raúl Araya
 6   Servicio de Endoscopia y Gastroenterología de la Clínica Universidad de Los Andes y del Hospital Militar de Santiago y Clínica Universidad de los Andes, Santiago, Chile
,
Vítor Arantes
 7   Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Hospital Mater Dei Contorno, Belo Horizonte, Brasil
,
Elymir S. Galvis-García
 8   Department of Endoscopy. Hospital General de Mexico “Dr. Eduardo Liceaga,” Mexico City, Mexico
,
Marisi Meza-Caballero
 2   Gástrica, Centro Avanzado en Endoscopia y Estudios Funcionales, Mexico City, Mexico
,
Blanca Sinahi García-Aguilar
 2   Gástrica, Centro Avanzado en Endoscopia y Estudios Funcionales, Mexico City, Mexico
,
Arturo Reding-Bernal
 9   Research Division, Hospital General de Mexico “Dr. Eduardo Liceaga,” Mexico City, Mexico
,
Noriya Uedo
10   Osaka International Cancer Institute, Department of Gastrointestinal Oncology, Osaka, Japan
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Abstract

Background and study aims The light blue crest observed in narrow band imaging endoscopy has high diagnostic accuracy for diagnosis of gastric intestinal metaplasia (GIM). The objective of this prospective study was to evaluate the diagnostic accuracy of magnifying i-scan optical enhancement (OE) imaging for diagnosing the LBC sign in patients with different levels of risk for gastric cancer in a Mexican clinical practice.

Patients and methods Patients with a history of peptic ulcer and symptoms of dyspepsia or gastroesophageal reflux disease were enrolled. Diagnosis of GIM was made at the predetermined anatomical location and white light endoscopy and i-scan OE Mode 1 were captured at the two predetermined biopsy sites (antrum and pyloric regions).

Results A total of 328 patients were enrolled in this study. Overall GIM prevalence was 33.8 %. The GIM distribution was 95.4 % in the antrum and 40.5 % in the corpus. According to the Operative Link on Gastritis/Intestinal-Metaplasia Assessment staging system, only two patients (1.9 %) were classified with high-risk stage disease. Sensitivity, specificity, positive​ and negative predictive values, positive and negative likelihood ratios, and accuracy of both methods (95 % C. I.) were 0.50 (0.41–0.60), 0.55 (0.48–0.62), 0.36 (0.31–0.42), 0.68 (0.63–0.73), 1.12 (0.9–1.4), 0.9 (0.7–1.1), and 0.53 (0.43–0.60) for WLE, and 0.96 (0.90–0.99), 0.91 (0.86–0.94), 0.84 (0.78–0.89), 0.98 (0.94–0.99), 10.4 (6.8–16), 0.05 (0.02–0.12), and 0.93 (0.89–0.95), respectively. The kappa concordance was 0.67 and the reliability coefficient was 0.7407 for interobserver variability.

Conclusions Our study demonstrated the high performance of magnifying i-scan OE imaging for endoscopic diagnosis of GIM in Mexican patients.



Publication History

Received: 14 July 2021

Accepted after revision: 11 January 2022

Article published online:
14 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2022; 54(05): 527-527
DOI: 10.1055/a-1736-8035

 

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