Endoscopic diagnosis of intestinal metaplasia in gastric mucosa

Abstract

Objective To estimate the feasibility and accuracy of endoscopic diagnosis of intestinal metaplasia (IM) Methods To observe the gastric mucosal patterns in detail with magnifying and routine gastroscope and 3 pieces of biopsy were taken from the lesser curvature of antrum, corpus, and grof antrum, respectively, in each patient. To define the main pattern of IM and endoscopic diagnostic rate in comparison with the pathologic result as control. Results Four patterns of IM defined as follows: yellowish nodules, whitish nodules, fish-scale-like and diffused irregular uneven nodules. The specificity of endoscopic diagnosis as controlled with pathology was 95.5% (128/134),the general sensitivity was 38.9% (128/ 329) . But in the mild, moderate and severe degree of IM, there was different sensitivity, it was 23.8%,48.5% and 51.7% respectively. The sensitivity of magnifying endoscopic diagnosis was 47.5%, 78.5% and 75.4% respectively. It was much better than routine endoscopy (P ＞ 0.05) . Conclusion Endoscopic patterns of IM could be divided into four types: yellowish nodules, whitish nodules, fish-scale-like and diffused irregular uneven nodules. The endoscopic diagnosis rate correlated to the degree of IM. The diagnostic accuracy of magnifying endoscopy is much better than routine endoscopy.