The Clinical Value Of Narrow Band Imging Endoscopy In Diagnosis Of Early Gastric Cancer And Precancerous Lesions

ObjectiveTo investigate the clinical value of narrow band imaging(NBI) in diagnosis of early gastric cancer (EGC) and precancerous lesions.Methods53 patients were enrolled.Routine endoscopy followed by narrow band imaging (NBI), then chromoendoscopy (0.2% indigo carmine) combined magnifying endoscopy was sequentially used. The quality of the gastric lesions, pits and microvascularity were evalued. When NBI was used,the gastric pits were observed according to Tanaka patterns and a light blue crest (LBC) on the epithelial surface was seen,and the biopsy samples were taken in suspicious area.Then early gastric cancer(EGC) ones needed endoscopic therapy or surgery.Result(1) Visualization of silhouette of gastric lesions by NBI endoscopy and chromoendoscopy were clearer than the convention-al endoscopy.And there was no significant difference between NBI endoscopy and chromoendoscopy. Visualization of gastric pit and microvascularity by NBI combinded with magnifying endo-scopy was clearer than the magnifying endoscopy and magnifying chromoendoscopy.(2)Of 53 patients, gastric atrophy in 10 cases, intestinal metaplasis in 18 case, dysplasia in 9 cases and EGC in 2 cases.TypeⅢwas usually found in gastic atrophy,typeⅢorⅣin intestinal metaplasis,typeⅣin dysplasia and EGC.The sensitivety predictive value of NBI for the diagnosis of gastric atrophy, intestinal metaplasis and dysplasia were 90%,90.9%,88.9 %, respectively.(3)NBI combined with magnify-ing endoscopy may clearly observe light blue crest(LBC),the appearance of LBC correlated with histological evidence of intestinal metaplasia with a sensitivity of 88.9%,a specificity of 82.8%,but the LBC grading is not associate with appearance of intestinal metaplasia. (X2=0.375,P=0.829)(4)Among these patients,the accuracy, sensitivity and specificity of diagnosis in gastric cancer and precancerous lesions all have insignific-ant deviation between NBI combined with magnifying endoscopy and magnifying Chromoendoscopy(χ2=1.603,P=0.205;χ2=1.984,P=0.159;χ2=0.391,P=0.532)(5)Among these patients,the evaluation of five pit patterns were different insignigicantly between NBI combined with magnifying endoscopy and magnifying Chromoendoscopy. (P=0.893)ConclusionsNarrow band imaging (NBI) is a new technique, which is not only very easy to operated, but also can capture optimal view of gastric lesions, pits and microvascularity. NBI may help predict in vivo histologic diagnosis of gastric pathologic conditions with a good degree of accuracy, and it is always helpful for improving the accuracy of early gastric cancer and precancerous lesions on endoscopic target biopsies.