医学
肠化生
内窥镜检查
病理
化生
胃肠病理学
胃肠病学
放射科
内科学
发育不良
作者
Guanpo Zhang,Jin Zheng,Linfu Zheng,Shentong Yu,Chuanshen Jiang,Wulian Lin,Dazhou Li,Lijuan Qu,Wen Wang
标识
DOI:10.1080/00365521.2020.1849385
摘要
Objective Cumulative evidence suggests that linked color imaging (LCI) can be used to identify gastric intestinal metaplasia (GIM). We aimed to develop endoscopic grading for GIM (EGGIM) with LCI.Methods Two hundred and seventy-seven patients who underwent high-resolution white-light gastroscopy followed by LCI for EGGIM estimation were included. LCI was performed for the entire mucosa, and images of five areas each were recorded from the lesser and greater curvatures of the antrum and corpus, and for the incisura. For each area, scores of 0 (no GIM), 1 (focal GIM, ≤30% of the area), and 2 (extensive GIM, >30% of the area) were attributed for 10 points. If GIM was suspected based on endoscopy findings, targeted biopsies were performed; if GIM was not evident, random biopsies were performed according to the Sydney system to estimate the operative link on GIM (OLGIM).Results GIM was staged as OLGIM 0, I, II, III, and IV in 136, 70, 37, 28, and 6 patients, respectively. For OLGIM III/IV diagnosis, the area under the receiver operating curve was 0.949 (95% CI 0.916–0.972). EGGIM of 4, with sensitivity and specificity of 94.12% (95% CI 80.3%–99.3%) and 86.42% (95% CI 81.5%–90.5%), respectively, was determined the best cut-off value for identifying OLGIM III/IV patients.Conclusions Our findings demonstrated the ability of EGGIM for diagnosing the extent of intestinal metaplasia and showed that EGGIM is related to OLGIM staging. EGGIM of 4 was the best cut-off value for identifying OLGIM III/IV patients.
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