ADVANCES IN ENDOSCOPIC DIAGNOSIS OF GASTRIC INTESTINAL METAPLASIA BY IMAGE-ENHANCED ENDOSCOPY

Abstract

Gastric intestinal metaplasia is associated with the risk of differentiated gastric cancer. Due to the remarkable development of image-enhanced endoscopy (IEE) represented by narrow-band imaging (NBI), various findings have been reported about the diagnosis of gastric intestinal metaplasia. Points in the diagnosis of gastric intestinal metaplasia by magnifying endoscopy with NBI (M-NBI) are firstly to evaluate the presence or absence of indicators specific to metaplasia [light blue crest (LBC), white opaque substance (WOS), marginal turbid band (MTB)], and secondly to determine the presence or absence of villous-like change of the marginal crypt epithelium (MCE) regarding the micro-surface pattern. By performing these observations in real time during endoscopy, it may be possible to accurately diagnose the localization of intestinal metaplastic mucosa spreading multifocally and multicentrically without obtaining biopsy specimens, and to perform appropriate risk stratification of gastric cancers.