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Lasers in Medical Science

, Volume 33, Issue 8, pp 1757–1762 | Cite as

Ability of blue laser imaging with magnifying endoscopy for the diagnosis of gastric intestinal metaplasia

  • Honglei ChenEmail author
  • Yanan Liu
  • Yi Lu
  • Xutao Lin
  • Qiuning Wu
  • Jiacheng Sun
  • Chujun LiEmail author
Original Article

Abstract

We aimed to determine the utility of blue laser imaging (BLI) with magnifying endoscopy (BLI-ME) for the prediction and diagnosis of gastric intestinal metaplasia (GIM). Participants, aged between 40 and 75 years, undergoing gastroscopy from January to April 2017 were included in this study. The ability of BLI-ME and white light endoscopy (WLE) to detect GIM was assessed by comparing the endoscopic findings with the histological findings. The correlation between the grades of light blue crest (LBC) appearance and histology grade of GIM was calculated. We included 100 participants in this study. GIM was diagnosed in 27 participants; 20 participants were detected by both BLI and WLE, four by BLI only, and three exclusively by random biopsies. The values of sensitivity, specificity, positive predictive values, and negative predictive values for detecting GIM were 34.9, 38.9, 25.4, and 57.1%, respectively, for WLE and 88.9, 96.7, 94.1, and 93.3%, respectively, for BLI-ME. The diagnostic accuracy for GIM was 43% for WLE and 94.0% for BLI-ME. A good correlation between the grades of LBC and the grades of GIM on histology was observed (P < 0.01). BLI-ME achieved a good diagnostic efficiency for detection of GIM. LBC seen on BLI-ME is a typical indicator of GIM.

Keywords

Blue laser imaging White light endoscopy Magnifying endoscopy Intestinal metaplasia Detection 

Notes

Funding information

This study was supported by the National Key Clinical Discipline and Guangdong Institute of Gastroenterology. This study was also funded by the Guangdong province medical science and technology research fund project (grant number: A2017273). This funding supported the work on data collection, analysis, and interpretation and writing of the manuscript.

Compliance with ethical standards

Conflict of interest

Honglei Chen has received funding from Guangdong province medical science and technology research fund project (grant number: A2017273). For the remaining authors, none were declared.

Ethical approval

The study was approved by the Ethics Committee of the Sixth Affiliated Hospital, Sun Yat-sen University, and has been performed in accordance with the Declaration of Helsinki. The study was registered with Chinese Clinical Trial Registry (ChiCTR-DDD-17011381).

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Lage J, Uedo N, Dinis-Ribeiro M, Yao K (2016) Surveillance of patients with gastric precancerous conditions. Best Pract Res Clin Gastroenterol 30(6):913–922.  https://doi.org/10.1016/j.bpg.2016.09.004 CrossRefPubMedGoogle Scholar
  2. 2.
    Gomez JM, Wang AY (2014) Gastric intestinal metaplasia and early gastric cancer in the west: a changing paradigm. Gastroenterol Hepatol (N Y) 10(6):369–378Google Scholar
  3. 3.
    Shichijo S, Hirata Y, Niikura R, Hayakawa Y, Yamada A, Ushiku T, Fukayama M, Koike K (2016) Histologic intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication. Gastrointest Endosc 84(4):618–624.  https://doi.org/10.1016/j.gie.2016.03.791 CrossRefPubMedGoogle Scholar
  4. 4.
    Genta RM, Sonnenberg A (2015) Characteristics of the gastric mucosa in patients with intestinal metaplasia. Am J Surg Pathol 39(5):700–704.  https://doi.org/10.1097/PAS.0000000000000384 CrossRefPubMedGoogle Scholar
  5. 5.
    Ballester V, Cruz-Correa M (2014) Endoscopic surveillance of gastrointestinal premalignant lesions: current knowledge and future directions. Curr Opin Gastroenterol 30(5):477–483.  https://doi.org/10.1097/MOG.0000000000000090 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Dixon MF, Genta RM, Yardley JH, Correa P (1996) Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20(10):1161–1181CrossRefGoogle Scholar
  7. 7.
    Li Z, Zuo XL, Yu T, Gu XM, Zhou CJ, Li CQ, Ji R, Li YQ (2014) Confocal laser endomicroscopy for in vivo detection of gastric intestinal metaplasia: a randomized controlled trial. Endoscopy 46(4):282–290.  https://doi.org/10.1055/s-0033-1359215 CrossRefPubMedGoogle Scholar
  8. 8.
    Kikuste I, Stirna D, Liepniece-Karele I, Leja M, Dinis-Ribeiro M (2014) The accuracy of flexible spectral imaging colour enhancement for the diagnosis of gastric intestinal metaplasia: do we still need histology to select individuals at risk for adenocarcinoma? Eur J Gastroenterol Hepatol 26(7):704–709.  https://doi.org/10.1097/MEG.0000000000000108 CrossRefPubMedGoogle Scholar
  9. 9.
    Lim LG, Yeoh KG, Srivastava S, Chan YH, Teh M, Ho KY (2013) Comparison of probe-based confocal endomicroscopy with virtual chromoendoscopy and white-light endoscopy for diagnosis of gastric intestinal metaplasia. Surg Endosc 27(12):4649–4655.  https://doi.org/10.1007/s00464-013-3098-x CrossRefPubMedGoogle Scholar
  10. 10.
    Uedo N, Ishihara R, Iishi H, Yamamoto S, Yamamoto S, Yamada T, Imanaka K, Takeuchi Y, Higashino K, Ishiguro S, Tatsuta M (2006) A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy 38(8):819–824.  https://doi.org/10.1055/s-2006-944632 CrossRefPubMedGoogle Scholar
  11. 11.
    Capelle LG, Haringsma J, de Vries AC, Steyerberg EW, Biermann K, van Dekken H, Kuipers EJ (2010) Narrow band imaging for the detection of gastric intestinal metaplasia and dysplasia during surveillance endoscopy. Dig Dis Sci 55(12):3442–3448.  https://doi.org/10.1007/s10620-010-1189-2 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Song J, Zhang J, Wang J, Guo X, Wang J, Liu Y, Dong W (2014) Meta-analysis: narrow band imaging for diagnosis of gastric intestinal metaplasia. PLoS One 9(4):e94869.  https://doi.org/10.1371/journal.pone.0094869 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Okubo M, Tahara T, Shibata T, Yonemura J, Yoshioka D, Kamiya Y, Nakamura M, Arisawaz T, Ohmiya N, Hirata I (2014) Light blue crest and ridge/villous patterns in the uninvolved gastric antrum by magnifying NBI endoscopy correlate with serum pepsinogen and gastric cancer occurrence. Hepato-Gastroenterology 61(130):525–528PubMedGoogle Scholar
  14. 14.
    Savarino E, Corbo M, Dulbecco P, Gemignani L, Giambruno E, Mastracci L, Grillo F, Savarino V (2013) Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia. World J Gastroenterol 19(17):2668–2675.  https://doi.org/10.3748/wjg.v19.i17.2668 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Nakano A, Hirooka Y, Yamamura T, Watanabe O, Nakamura M, Funasaka K, Ohno E, Kawashima H, Miyahara R, Goto H (2017) Comparison of the diagnostic ability of blue laser imaging magnification versus pit pattern analysis for colorectal polyps. Endosc Int Open 5(4):E224–E231.  https://doi.org/10.1055/s-0043-102400 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Yoshida N, Yagi N, Inada Y, Kugai M, Okayama T, Kamada K, Katada K, Uchiyama K, Ishikawa T, Handa O, Takagi T, Konishi H, Kokura S, Yanagisawa A, Naito Y (2014) Ability of a novel blue laser imaging system for the diagnosis of colorectal polyps. Dig Endosc 26(2):250–258.  https://doi.org/10.1111/den.12127 CrossRefPubMedGoogle Scholar
  17. 17.
    Togashi K, Nemoto D, Utano K, Isohata N, Kumamoto K, Endo S, Lefor AK (2016) Blue laser imaging endoscopy system for the early detection and characterization of colorectal lesions: a guide for the endoscopist. Ther Adv Gastroenterol 9(1):50–56.  https://doi.org/10.1177/1756283X15603614 CrossRefGoogle Scholar
  18. 18.
    Tomie A, Dohi O, Yagi N, Kitae H, Majima A, Horii Y, Kitaichi T, Onozawa Y, Suzuki K, Kimura-Tsuchiya R, Okayama T, Yoshida N, Kamada K, Katada K, Uchiyama K, Ishikawa T, Takagi T, Handa O, Konishi H, Naito Y, Itoh Y (2016) Blue laser imaging-bright improves endoscopic recognition of superficial esophageal squamous cell carcinoma. Gastroenterol Res Pract 2016:6140854.  https://doi.org/10.1155/2016/6140854 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Kaneko K, Oono Y, Yano T, Ikematsu H, Odagaki T, Yoda Y, Yagishita A, Sato A, Nomura S (2014) Effect of novel bright image enhanced endoscopy using blue laser imaging (BLI). Endosc Int Open 2(4):E212–E219.  https://doi.org/10.1055/s-0034-1390707 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Shimoda R, Sakata Y, Fujise T, Yamanouchi K, Tsuruoka N, Hara M, Nakayama A, Yamaguchi D, Akutagawa T, Fujimoto K, Iwakiri R (2017) The adenoma miss rate of blue-laser imaging vs. white-light imaging during colonoscopy: a randomized tandem trial. Endoscopy 49(2):186–190.  https://doi.org/10.1055/s-0042-118450 CrossRefPubMedGoogle Scholar
  21. 21.
    Sha J, Wang P, Zhu B, Zhu M, Li X, Gao F (2017) Acetic acid enhanced narrow band imaging for the diagnosis of gastric intestinal metaplasia. PLoS One 12(1):e0170957.  https://doi.org/10.1371/journal.pone.0170957 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, Dixon MF, Fenoglio-Preiser CM, Flejou JF, Geboes K, Hattori T, Hirota T, Itabashi M, Iwafuchi M, Iwashita A, Kim YI, Kirchner T, Klimpfinger M, Koike M, Lauwers GY, Lewin KJ, Oberhuber G, Offner F, Price AB, Rubio CA, Shimizu M, Shimoda T, Sipponen P, Solcia E, Stolte M, Watanabe H, Yamabe H (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47(2):251–255CrossRefGoogle Scholar
  23. 23.
    Dohi O, Yagi N, Majima A, Horii Y, Kitaichi T, Onozawa Y, Suzuki K, Tomie A, Kimura-Tsuchiya R, Tsuji T, Yamada N, Bito N, Okayama T, Yoshida N, Kamada K, Katada K, Uchiyama K, Ishikawa T, Takagi T, Handa O, Konishi H, Naito Y, Yanagisawa A, Itoh Y (2017) Diagnostic ability of magnifying endoscopy with blue laser imaging for early gastric cancer: a prospective study. Gastric Cancer 20(2):297–303.  https://doi.org/10.1007/s10120-016-0620-6 CrossRefPubMedGoogle Scholar
  24. 24.
    Yoshifuku Y, Sanomura Y, Oka S, Kurihara M, Mizumoto T, Miwata T, Urabe Y, Hiyama T, Tanaka S, Chayama K (2017) Evaluation of the visibility of early gastric cancer using linked color imaging and blue laser imaging. BMC Gastroenterol 17(1):150.  https://doi.org/10.1186/s12876-017-0707-5 CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Kimura-Tsuchiya R, Dohi O, Fujita Y, Yagi N, Majima A, Horii Y, Kitaichi T, Onozawa Y, Suzuki K, Tomie A, Okayama T, Yoshida N, Kamada K, Katada K, Uchiyama K, Ishikawa T, Takagi T, Handa O, Konishi H, Kishimoto M, Naito Y, Yanagisawa A, Itoh Y (2017) Magnifying endoscopy with blue laser imaging improves the microstructure visualization in early gastric cancer: comparison of magnifying endoscopy with narrow-band imaging. Gastroenterol Res Pract 2017:8303046.  https://doi.org/10.1155/2017/8303046 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Jiang JX, Liu Q, Zhao B, Zhang HH, Sang HM, Djaleel SM, Zhang GX, Xu SF (2017) Risk factors for intestinal metaplasia in a southeastern Chinese population: an analysis of 28,745 cases. J Cancer Res Clin Oncol 143(3):409–418.  https://doi.org/10.1007/s00432-016-2299-9 CrossRefPubMedGoogle Scholar
  27. 27.
    Goda K, Tajiri H, Ikegami M, Urashima M, Nakayoshi T, Kaise M (2007) Usefulness of magnifying endoscopy with narrow band imaging for the detection of specialized intestinal metaplasia in columnar-lined esophagus and Barrett’s adenocarcinoma. Gastrointest Endosc 65(1):36–46.  https://doi.org/10.1016/j.gie.2006.03.938 CrossRefPubMedGoogle Scholar
  28. 28.
    An JK, Song GA, Kim GH, Park DY, Shin NR, Lee BE, Woo HY, Ryu DY, Kim DU, Heo J (2012) Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia. BMC Gastroenterol 12:169.  https://doi.org/10.1186/1471-230X-12-169 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastrointestinal Endoscopy, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouPeople’s Republic of China

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