scholarly journals Endoscopic Scoring System for Gastric Atrophy and Intestinal Metaplasia: Correlation with OLGA and OLGIM Staging: A Single Center Prospective Pilot Study

2021 ◽  
Author(s):  
Hee Kyong Na ◽  
Kee Don Choi ◽  
Young Soo Park ◽  
Hwa Jung Kim ◽  
Ji Yong Ahn ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Predictive Value ◽  
Scoring System ◽  
Narrow Band Imaging ◽  
Gastric Atrophy ◽  
Stage Iii ◽  
Gastric Intestinal Metaplasia ◽  
Endoscopic Score ◽  
Greater Curvature ◽  
Sensitivity Specificity

Abstract Background/Aims: We aimed to develop an endoscopic scoring system to evaluate atrophic and intestinal metaplasia using narrow-band imaging (NBI) and near focus mode (NFM) to compare endoscopic scores with the Operative link for gastritis assessment (OLGA) and the Operative link for gastric intestinal metaplasia assessment (OLGIM). Methods: A total of 51 patients who underwent diagnostic esophagogastroduodenoscopy were prospectively enrolled and endoscopic scoring using NBI and NFM was performed. Four areas (the lesser and greater curvatures of the antrum and the lesser and greater curvature side of the corpus) were observed and biopsies were taken. The degree of atrophy was scored from 0 to 2 according to the Kimura-Takemoto classification (0: C0-1, 1: C2-3, 2: O1-3). The degree of metaplasia was scored from 0 to 4 (0: no metaplasia, 1: presence of metaplasia at the antrum, 2: presence of metaplasia at the corpus, add score 1: presence of metaplasia for 1/2> observed field of the picture at the antrum, add score 2: 1/2 > observed field of the picture at the corpus). The endoscopic scores were compared to the OLGA and OLGIM staging. Results: The correlation coefficient for atrophy between the endoscopic and histologic scores was 0.70 (95% CI: 0.52–0.81 p <0.001) and for metaplasia, it was 0.75 (95% CI: 0.60–0.85; p <0.001). For atrophic gastritis, endoscopic score > 1 correlated with OLGA stage III and IV with a sensitivity, specificity, positive predictive value, negative predictive value, and agreement of 88%, 74%, 75%, 87%, and 80.4%, respectively, and for metaplasia, an endoscopic score > 1 correlated with high OLGIM stage III and IV with 100%, 59%, 69%, 100%, and 78.4%, respectively. Conclusions: Endoscopic scoring for gastric atrophy and metaplasia using NBI-NFM correlate well with histologic staging.

scholarly journals Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study

Endoscopy ◽  
2018 ◽  
Vol 51 (06) ◽  
pp. 515-521 ◽  
Author(s):  
Gianluca Esposito ◽  
Pedro Pimentel-Nunes ◽  
Stefano Angeletti ◽  
Rui Castro ◽  
Diogo Libânio ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Narrow Band Imaging ◽  
Positive Likelihood Ratio ◽  
Gastric Intestinal Metaplasia ◽  
Sydney System ◽  
Greater Curvature ◽  
Sensitivity Specificity ◽  
First Time ◽  
Targeted Biopsies

Abstract Background Random biopsies are recommended to identify individuals at risk of gastric adenocarcinoma. Cumulative evidence suggests that narrow-band imaging (NBI) can be used to grade gastric intestinal metaplasia (GIM). We aimed to externally validate a classification of endoscopic grading of gastric intestinal metaplasia (EGGIM). Methods Consecutive patients in two centers were submitted to high resolution white-light gastroscopy followed by NBI to estimate EGGIM – a score (0 – 10) resulting from the sum of endoscopic assessments of GIM, scored as 0, 1, or 2 for no GIM, ≤ 30 %, or > 30 % of the mucosa, respectively, in five areas (lesser and greater curvature of both antrum and corpus, and incisura). If GIM was endoscopically suspected, targeted biopsies were performed; if GIM was not noticeable, random biopsies were performed according to the Sydney system to estimate the operative link on gastric intestinal metaplasia (OLGIM; the gold standard). Results 250 patients (62 % female; median age 55 years) were included. GIM was staged as OLGIM 0, I, II, III, IV in 136 (54 %), 15 (6 %), 52 (21 %), 34 (14 %), and 13 (5 %) patients, respectively. All patients with GIM except three were identifiable with targeted biopsies. For the diagnosis of OLGIM III/IV, the area under the ROC curve was 0.96 (95 % confidence interval [CI] 0.93 – 0.98) and by using the cutoff > 4, sensitivity, specificity, and positive likelihood ratio were 89 %, 95 %, and 16.5, respectively; results were similar (91 %, 95 %, and 18.1) when excluding patients with foveolar hyperplasia. Conclusions For the first time, an endoscopic approach was externally validated to determine the risk of gastric cancer without the need for biopsies. This can be used to simplify and individualize the management of patients with gastric precancerous conditions.

scholarly journals A novel method of grading gastric intestinal metaplasia based on the combination of subtype and distribution

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ning Wei ◽  
Zhiheng Zhong ◽  
Ruihua Shi
Keyword(s):  
Intestinal Metaplasia ◽  
Roc Curve ◽  
Predictive Value ◽  
Scoring System ◽  
Benign Lesion ◽  
Gastric Antrum ◽  
Lesion Group ◽  
Type I ◽  
Cross Sectional ◽  
Gastric Intestinal Metaplasia

Abstract Background Studies have shown the value of subtypes and distribution of gastric intestinal metaplasia (GIM) for prediction of gastric cancer. We aim to combine GIM subtypes and distribution to form a new scoring system for GIM. Methods This was a cross-sectional study. No GIM, type I, II, and III GIM of gastric antrum and corpus scored 0–3 points respectively. Then the severity of the whole stomach was calculated in two ways: 1. The gastric antrum and corpus scores were added together, with a score ranging from 0 to 6, which named “Subtype Distribution Score of Gastric Intestinal Metaplasia (SDSGIM)”. 2. Direct classification according to a table corresponding to that of OLGIM. We compared the SDSGIM among benign lesions, dysplasia, and cancer and drew receiver operating characteristic (ROC) curve to determine the optimal cut-off value. According to the cut-off value and the classification from the table, the predictive ability of these two methods were calculated. Results 227 patients were included. For SDSGIM, benign lesion group was significantly different from dysplasia or cancer group. Area under curve of ROC curve was 0.889 ± 0.023. The optimal cut-off value was 3. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SDSGIM for malignancy were 89.5%, 78.0%, 74.6%, 91.2% and 82.8%. And those for the second classification method were 84.2%, 82.6%, 77.7%, 87.9%, and 83.3% respectively. Conclusions This study firstly combined GIM subtypes with its distribution forming a novel scoring system, which showed high prediction accuracy for malignant lesions.

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

2021 ◽  
Vol 09 (04) ◽  
pp. E522-E529
Author(s):  
Hiroyoshi Iwagami ◽  
Noriya Uedo ◽  
Hon-Chi Yip ◽  
Satoki Shichijo ◽  
Takashi Kanesaka ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Cellular Structure ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Diagnostic Value ◽  
Gastric Intestinal Metaplasia ◽  
Crypt Epithelium ◽  
Diagnostic Values ◽  
Sensitivity Specificity ◽  
A Prospective Study

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.

scholarly journals Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Jin Kwang An ◽  
Geun Am Song ◽  
Gwang Ha Kim ◽  
Do Youn Park ◽  
Na Ri Shin ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Light Blue ◽  
Gastric Intestinal Metaplasia

A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy

Endoscopy ◽  
2006 ◽  
Vol 38 (8) ◽  
pp. 819-824 ◽  
Author(s):  
N. Uedo ◽  
R. Ishihara ◽  
H. Iishi ◽  
S. Yamamoto ◽  
S. Yamamoto ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
New Method ◽  
Gastric Intestinal Metaplasia

P.17.9 INTER- AND INTRA-OBSERVER RELIABILITY IN DETECTING GASTRIC INTESTINAL METAPLASIA BY MEANS OF NARROW BAND IMAGING WITH MAGNIFYING ENDOSCOPY

2013 ◽  
Vol 45 ◽  
pp. S206
Author(s):  
L. Gemignani ◽  
M. Corbo ◽  
P. Dulbecco ◽  
S. De Conca ◽  
M. Giacchino ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastric Intestinal Metaplasia ◽  
Observer Reliability

Narrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial

2017 ◽  
Vol 86 (5) ◽  
pp. 857-865 ◽  
Author(s):  
James L. Buxbaum ◽  
David Hormozdi ◽  
Mario Dinis-Ribeiro ◽  
Christianne Lane ◽  
Diogo Dias-Silva ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
White Light ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Gastric Intestinal Metaplasia ◽  
Blinded Trial ◽  
Mapping Biopsy

New Diagnostic Modality of Gastric Intestinal Metaplasia: Narrow Band Imaging System with Magnifying Endoscopy

2005 ◽  
Vol 61 (5) ◽  
pp. AB184 ◽  
Author(s):  
Noriya Uedo ◽  
Ryu Ishihara ◽  
Hiroyasu Iishi ◽  
Hiroyuki Narahara ◽  
Tomiko Mikuni ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Imaging System ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Diagnostic Modality ◽  
Gastric Intestinal Metaplasia
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