Details

Autor(en) / Beteiligte

• White, Jonathan R.
• Sami, Sarmed S.
• Reddiar, Dona
• Mannath, Jayan
• Ortiz-Fernández-Sordo, Jacobo
• Beg, Sabina
• Scott, Robert
• Thiagarajan, Prarthana
• Ahmad, Saqib
• Parra-Blanco, Adolfo
• Kasi, Madhavi
• Telakis, Emmanouil
• Sultan, Alyshah A.
• Davis, Jillian
• Figgins, Adam
• Kaye, Philip
• Robinson, Karen
• Atherton, John C.
• Ragunath, Krish

Titel

Narrow band imaging and serology in the assessment of premalignant gastric pathology

Ist Teil von

• Scandinavian journal of gastroenterology, 2018-12, Vol.53 (12), p.1611-1618

Ort / Verlag

England: Taylor & Francis

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Patient outcomes in gastric adenocarcinoma are poor due to late diagnosis. Detecting and treating at the premalignant stage has the potential to improve this. Helicobacter pylori is also a strong risk factor for this disease. Aims: Primary aims were to assess the diagnostic accuracy of magnified narrow band imaging (NBI-Z) endoscopy and serology in detecting normal mucosa, H. pylori gastritis and gastric atrophy. Secondary aims were to compare the diagnostic accuracies of two classification systems using both NBI-Z and white light endoscopy with magnification (WLE-Z) and evaluate the inter-observer agreement. Methods: Patients were prospectively recruited. Images of gastric mucosa were stored with histology and serum for IgG H. pylori and Pepsinogen (PG) I/II ELISAs. Blinded expert endoscopists agreed on mucosal pattern. Mucosal images and serological markers were compared with histology. Kappa statistics determined inter-observer variability for randomly allocated images among four experts and four non-experts. Results: 116 patients were prospectively recruited. Diagnostic accuracy of NBI-Z for determining normal gastric mucosa was 0.87(95%CI 0.82-0.92), H. pylori gastritis 0.65(95%CI 0.55-0.75) and gastric atrophy 0.88(95%CI 0.81-0.94). NBI-Z was superior to serology at detecting gastric atrophy: NBI-Z gastric atrophy 0.88(95%CI 0.81-0.94) vs PGI/II ratio < 3 0.74(95%CI 0.62-0.85) p<.0001. Overall NBI-Z was superior to WLE-Z in detecting disease using two validated classifications. Inter-observer agreement was 0.63(95%CI 0.51-0.73). Conclusions: NBI-Z accurately detects changes in the GI mucosa which currently depend on histology. NBI-Z is useful in the detection of precancerous conditions, potentially improving patient outcomes with early intervention to prevent gastric cancer.