Utilidad de la imagen de banda estrecha para el estudio del esófago de Barrett

Abstract

IntroductionBarrett esophagus is a condition that develops when the normal epithelium is replaced by a columnar epithelium with caliciform cells, with a prevalence of 5%. The risk of adenocarcinoma of the esophagus is 0.5% per year. Virtual chromoendoscopy gives similar results to using stains, but with only at the push of a button, specifically helps to direct the taking of biopsies. ObjectiveDetermine the usefulness of the narrow band imaging (NBI) in the endoscopies of patients with suspected or known Barrett esophagus. Material and methodsAn diagnosis evaluation study was performed on the biopsies taken with light compared with NBI of all the consecutive patients that had an endoscopy with the suspicion of or a known Barrett esophagus in the Endoscopy Service of the Hospital Central Sur de Alta Especialidad de PEMEX in the period of the study. ResultsA total of 1,225 upper endoscopies were performed during the study period, with 127 biopsies taken due to the suspicion of Barrett esophagus (63 with white light and 64 with NBI). There were also 124 biopsies taken for follow-up of Barrett esophagus (71 with white light and 53 with NBI). The sensitivity and specificity of the white light endoscopies was 100% and 84%, respectively, and with NBI the sensitivity was 100% and specificity 93%. For the follow-up studies of Barrett esophagus with white light, the sensitivity and specificity were both 92%, and in the NBI follow-up studies the sensitivity was 92% and specificity 93%. ConclusionsThe use of NBI for studies of suspected Barrett esophagus increases the specificity and PPV compared with white light.