Diagnostic efficacy of magnifying endoscopy with narrow band imaging for gastric mucosal lesions

Abstract

Objective To study the diagnostic value of magnifying endoscopy with narrow band imaging(NBI-ME) for gastric neoplastic lesion and its role in developing diagnostic skills of less experienced endoscopists. Methods White light images and magnifying endoscopic images with narrow band imaging of 20 cases of early gastric lesions were collected from published literature. Thirty-seven endoscopists with various experiences were invited to a diagnosis workshop to study these cases. After a short training course of diagnosis, real time vote was performed and data were analyzed. Results All thirty-seven endoscopists finished the diagnosis workshop. Fourteen endoscopists(37.8%) had work experience of less than five years, and 22(59.5%) had experience in either magnifying endoscopy or narrow band imaging. The diagnostic accuracy of NBI-ME was significantly higher than that of white light imaging [(62.6±21.7)% VS(49.8±28.7)%, P=0.005], but was consistent in the 3 cases with lowest diagnostic accuracy, which were all benign including two cases of localized gastritis and one metaplasia. Comparison between the diagnostic accuracy rates of first and last seven cases showed there was no statistical difference [(55.8±26.3)% VS(69.0±27.1)%, P=0.377], neither was there when 22 experienced endoscopists in NBI-ME were excluded [(56.5±23.2)% VS(67.4±25.3)%, P=0.356]. Conclusion Magnifying endoscopy with narrow band imaging is superior to white light imaging in diagnosis of early gastric mucosal lesions. It is also helpful to improve diagnostic skills of less experienced endoscopists. But it may be of lower diagnostic accuracy for such benign lesion as gastric atrophy and intraepithelial metaplasia. Key words: Magnifying endoscopy; Narrow band imaging; Early gastric neoplasm; Training