Optical enhancement imaging versus acetic acid for detecting gastric intestinal metaplasia: A randomized, comparative trial
Optical enhancement imaging versus acetic acid for detecting gastric intestinal metaplasia: A randomized, comparative trial
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光学增强成像与乙酸检测胃肠化生：一项随机比较试验
DOI：
10.1016/j.dld.2020.02.010
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发表时间：
2020-06-01
影响因子：
4.5
通讯作者：
Li, Yan-Qing
中科院分区：
文献类型：
--
作者：
Ji, Rui;Liu, Jun;Li, Yan-Qing
背景和目的：胃肠上皮化生(GIM)的诊断仍具有挑战性。光学增强技术(OE)可以提高GIM的检测水平。在监测人群中，我们将GIM检测与OE、冰醋酸和悉尼活检法进行了比较。方法：前瞻性纳入连续的萎缩性胃炎或已知GIM患者。胃用高清晰度白光内窥镜检查，然后用OE或冰醋酸进行有针对性的活检(1：1随机)。随后，根据最新的悉尼系统进行了5次随机活检。结果：共有154名患者被随机抽取。OE和乙酸法与随机活检相比，GIM患者的比例更高(60.5%对35.5%，67.1%对31.5%；P<；两种比较均为0.0001)。联合使用靶向活检和随机活检可提供较高的GIM诊断率(OE组为78.9%，乙酸组为83.6%)。此外，图像增强内窥镜较白光内窥镜检查广泛性胃肠炎的比例显著增加(P=0.029，P=0.048)。结论：过氧乙酸乙酯和冰醋酸对胃肠道间质瘤的诊断具有可比性。在高危人群中，靶向活检和随机活检应互补使用。(C)2020年编辑意大利胃肠病学S.r.l.爱思唯尔有限公司出版。保留所有权利。
Background and aims: The diagnosis of gastric intestinal metaplasia (GIM) is still challenging. Optical Enhancement technology (OE) may improve the detection of GIM. We compared detection of GIM with OE, acetic acid and the Sydney biopsy protocol in a surveillance population.Methods: Consecutive patients with atrophic gastritis or known GIM were prospectively included. The stomach was examined with high definition whitelight endoscopy, followed by OE or acetic acid with targeted biopsies (1:1 randomisation). Subsequently, five random biopsies were taken according to the updated Sydney system.Results: A total of 154 patients were randomized. Higher proportions of patients with GIM were detected by OE and acetic acid versus random biopsy (60.5% vs 35.5%, 67.1% vs 31.5%, respectively; P < 0.0001 for both comparisons). The combined use of targeted biopsies and random biopsies provides high diagnostic yields for GIM (78.9% in OE group and 83.6% in acetic acid group). In addition, the proportion of extensive GIM was significantly increased when image enhanced endoscopy was used instead of white light endoscopy (P = 0.029, P = 0.048, respectively).Conclusions: OE and acetic acid showed comparable results diagnosing GIM in the study. Targeted biopsies plus random biopsies should be used complementary in high risk populations. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.