Jonathan R White
Narrow band imaging and serology in the assessment of premalignant gastric pathology
Sarmed S Sami
ROBERT SCOTT Rob.Scott@nottingham.ac.uk
Clinical Assistant Professor
Alyshah A Sultan
KAREN ROBINSON firstname.lastname@example.org
John C Atherton
Background: Patient outcomes in gastric adenocarcinoma are poor due to late diagnosis. Detecting and treating at the premalignant stage has the potential to improve this. Helicobacter pylori is also a strong risk factor for this disease.
Aims: Primary aims were to assess the diagnostic accuracy of magnified narrow band imaging (NBI-Z) endoscopy and serology in detecting normal mucosa, H. pylori gastritis and gastric atrophy. Secondary aims were to compare the diagnostic accuracies of two classification systems using both NBI-Z and white light endoscopy with magnification (WLE-Z) and evaluate the inter-observer agreement.
Methods: Patients were prospectively recruited. Images of gastric mucosa were stored with histology and serum for IgG H. pylori and Pepsinogen (PG) I/II ELISAs. Blinded expert endoscopists agreed on mucosal pattern. Mucosal images and serological markers were compared with histology. Kappa statistics determined inter-observer variability for randomly allocated images among four experts and four non-experts.
Results: 116 patients were prospectively recruited. Diagnostic accuracy of NBI-Z for determining normal gastric mucosa was 0.87(95%CI 0.82–0.92), H. pylori gastritis 0.65(95%CI 0.55–0.75) and gastric atrophy 0.88(95%CI 0.81–0.94). NBI-Z was superior to serology at detecting gastric atrophy: NBI-Z gastric atrophy 0.88(95%CI 0.81-0.94) vs PGI/II ratio
White, J. R., Sami, S. S., Reddiar, D., Mannath, J., Ortiz Fernández-Sordo, J., Beg, S., …Ragunath, K. (2019). Narrow band imaging and serology in the assessment of premalignant gastric pathology. Scandinavian Journal of Gastroenterology, 53(12), 1611-1618. https://doi.org/10.1080/00365521.2018.1542455
|Journal Article Type||Article|
|Acceptance Date||Oct 23, 2018|
|Online Publication Date||Jan 2, 2019|
|Publication Date||Jan 2, 2019|
|Deposit Date||Jan 10, 2019|
|Publicly Available Date||Jan 3, 2020|
|Journal||Scandinavian Journal of Gastroenterology|
|Publisher||Taylor & Francis Open|
|Peer Reviewed||Peer Reviewed|
|Keywords||Endoscopy, narrow band imaging, white light endoscopy, serology, H. pylori gastritis, gastric atrophy, intestinal metaplasia|
|Additional Information||This is an Accepted Manuscript of an article published by Taylor & Francis in Scandinavian Journal of Gastroenterology
on 2 Jan 2019, available online: http://www.tandfonline.com/10.1080/00365521.2018.1542455.
Corresponding author: Jonathan R White
Corresponding author email: email@example.com
Narrow Band Imaging And Serology In The Assessment Of Premalignant Gastric Pathology Final Accepted Version
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