Diagnostic Value Of EPK-i Endoscopy In Chronic Atrophic Gastritis

Objective To investigate Pentax Endoscopy EPK-i scan series for the diagnosic value of mucosal morphology in chronic atrophic gastritis (CAG).Methods The conformation to endoscopic manifestations and pathologic diagnasis of400CAG patients were studied, and compare the ordinary white pattern and special mode of typical manifestations of discovery rate, as well as the sensitivity、specificity and positive predictive value of different menifestations in CAG were calculated respectively.Results In400cases described as mucosal thinning, vascular (V) pattern found169cases, compared with the common light pattern103cases, the difference was statistically significant(χ2=24.265, P=0.000<0.05); In400cases described as mucosal roughness, gastric (G) pattern was found in211cases, crypt (P) pattern was found in198cases, and the common light pattern was found in157cases. The difference was not statistically significant in the first two comparison (χ2=0.845, P=0.358>0.05), but the difference was statistically significant in common mode comparied with G pattern or P pattern (P<0.05). In the white light, Of the400CAG cases, histologic diagnosis of CAG were279cases, chronic superficial gastritis (CSG) were121cases, and the coincidence rate of diagnosis between endoscopy and pathology was69.75%. The sensitivities of various endoscopic manifestations in CAG were5.02%～35.13%. One manifestation of the specificity and positive predictive value was low, but the performance of two kinds of coexistence pattern had high specificity and positive predictive about93.39%、95.87%and79.49%、89.36%, at the same time, the three existing were100%. Mucosal rough with yellowish nodule、porcelain white nodules、 scaly change attained the accurate rate of91.43%、86.36%、100%to pathological diagnosis in intestinal metaplasia.Conclusion The special modes have guilding significance in fingding typical mucosal morphology. We can improve the diagnosis of CAG by multi-mode joint. Two or more endoscopic manifestations on CAG had high accuracy rate. Mucosal rough with yellowish nodule、porcelain white nodules、scaly change have a guiding significance on finding intestinal metaplasia.