Abstract :
Background: Gastric intestinal metaplasia (GIM) is a premalignant lesion for gastric cancer. Although magnifying Fujinon intelligence chromoendoscopy (FICE) or narrow band imaging (NBI) provides a higher sensitivity over white light endoscopy to diagnose GIM, its sensitivity is still suboptimal.Recently, probe-based confocal laser endomicroscope (pCLE) has been introduced as a highly magnified imaging (x1,000) that may be comparable to standard histology. However, only few reports on the results of pCLE to diagnose GIM are available.
Objective: To evaluate the correlation between the image from pCLE and the change of gastric mucosa.
Methods: Fifty patients, previously diagnosed GIM, underwent EGD with magnified FICE plus pCLE by single endoscopist. Standard and magnified (x100) FICE were used as a screening tool to target the GIM lesion for pCLE. Biopsies were taken from both GIM and non-GIM suspicious epithelium in each patient. Our goal standard was histology that read by a clinically-blinded GI pathologist. The results were assessed by agreement kappa) between images from pCLE and pathological reports.
Results: Of those 43 patients with suspected GIM by pCLE, 38 were confirmed GIM by histology. The kappa is 0.81 which is the almost perfect agreement of both diagnostic tools. There was no gastric cancer detected in any patients.
Conclusion: There is a very good correlation between the image from pCLE and the change of gastric mucosa, especially GIM. |
file/Thai-Journal-of-gastroenterology-vol-13-no-3-4820330.pdf