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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(04): E522-E529
DOI: 10.1055/a-1352-2500
Original article

Ultra-magnifying narrow-band imaging for endoscopic diagnosis of gastric intestinal metaplasia: a pilot image analysis study

Hiroyoshi Iwagami
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Noriya Uedo
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Hon-Chi Yip
2   Division of Upper Gastro-intestinal and Metabolic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
,
Satoki Shichijo
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Takashi Kanesaka
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Akira Maekawa
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Sachiko Yamamoto
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Koji Higashino
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Yoji Takeuchi
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Ryu Ishihara
1   Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
,
Shin-ichi Nakatsuka
3   Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
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Abstract

Background and study aims Narrow-band imaging (NBI) with or without magnification has recently been used for diagnosis of gastric intestinal metaplasia (GIM). Endocytoscopy is a newly developed endoscopic technique that enables ultra-high (500 ×) magnification of the digestive tract mucosa. This study aimed to analyze the ultra-magnifying NBI characteristics of GIM.

Patients and methods This was a retrospective observational study conducted in a cancer referral center. Patients who underwent ultra-magnifying NBI of the gastric mucosa using endocytoscopy were eligible. A soft black cap was used for non-contact observation. We compared the characteristic findings of GIM by ultra-magnifying NBI of metaplastic and non-metaplastic mucosae. A reference standard for GIM in this study was conventional magnifying NBI findings of GIM.

Results We obtained 28 images of metaplastic mucosa and 32 of non-metaplastic mucosa from 38 patients. Ultra-magnifying NBI revealed the cobblestone-like cellular structure in the marginal crypt epithelium of metaplastic and non-metaplastic mucosa. Diagnostic values (sensitivity, specificity, accuracy and kappa value [95 % confidence interval]) for the heterogeneous cellular structure and rough contour of the marginal crypt epithelium were 82 % (68 %–96 %), 94 % (85 %–100 %), 88 % (80 %–96 %), and 0.70, and 86 % (73 %–99 %), 94 % (85 %–100 %), 90 % (82 %–98 %), and 0.71, respectively.

Conclusions The characteristic ultrastructural features of GIM were identified by ultra-magnifying NBI, warranting validation of diagnostic value in a prospective study.



Publication History

Received: 10 May 2020

Accepted: 24 November 2020

Article published online:
17 March 2021

© 2021. 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 commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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