PMID- 24901816
OWN - NLM
STAT- MEDLINE
DCOM- 20150120
LR  - 20191210
IS  - 1473-5687 (Electronic)
IS  - 0954-691X (Linking)
VI  - 26
IP  - 7
DP  - 2014 Jul
TI  - The accuracy of flexible spectral imaging colour enhancement for the diagnosis of 
      gastric intestinal metaplasia: do we still need histology to select individuals 
      at risk for adenocarcinoma?
PG  - 704-9
LID - 10.1097/MEG.0000000000000108 [doi]
AB  - BACKGROUND: Targeting biopsies on the basis of visual recognition of mucosal 
      changes in the stomach instead of the currently accepted random biopsy sampling 
      may be attractive. AIM: The aim of this study was to evaluate the accuracy of 
      endoscopic findings using flexible spectral imaging colour enhancement (FICE) for 
      intestinal metaplasia (IM) in the gastric mucosa. METHODS: A consecutive cohort 
      of 126 individuals aged over 50 years (27% men) was subjected to upper endoscopy 
      using FICE. Histological assessment (per patient and per biopsy) was considered 
      the gold standard to accuracy estimates. RESULTS: Histological assessment 
      revealed IM in 50% of the individuals [OLGIM (operative link on gastric 
      intestinal metaplasia assessment) stages I-IV]. Overall, endoscopy presented 
      sensitivities, specificities, positive likelihood ratio, negative likelihood 
      ratio and accuracies per patient of 60% [95% confidence interval (95% CI) 48-72], 
      87% (95% CI 79-95), 4.7 (95% CI 2.4-93), 0.45 (95% CI 0.33-0.62) and 74% (95% CI 
      0.66-0.82), respectively, for IM diagnosis and 71% (95% CI 37-100), 87% (95% CI 
      79-95), 5.6 (95% CI 2.5-12.5), 0.32 (95% CI 0.10-1.0) and 86% (95% CI 77-94), 
      respectively, for selecting individuals with OLGIM (III-IV). The proportions of 
      agreement (and kappa values) for IM in the antrum and the corpus were 75% (0.37) and 
      81% (0.19), respectively. CONCLUSION: FICE endoscopy yielded favourable results 
      in the endoscopic diagnosis of IM of the gastric mucosa, and this is a very 
      practical and easy method to use in daily clinical practice for unselected 
      patients. Our study demonstrated a good specificity for FICE endoscopy to detect 
      IM in the stomach. Further improvement in disseminating and training of this 
      assessment is required to improve the reliability.
FAU - Kikuste, Ilze
AU  - Kikuste I
AD  - aFaculty of Medicine, University of Latvia bDigestive Diseases Centre GASTRO 
      cDepartment of Research, Riga East University Hospital dAcademic Histology 
      Laboratory, SIA eRiga East University Hospital, Riga, Latvia fCINTESIS, Porto 
      Faculty of Medicine gDepartment of Gastroenterology, Portuguese Oncology 
      Institute, Porto, Portugal.
FAU - Stirna, Dans
AU  - Stirna D
FAU - Liepniece-Karele, Inta
AU  - Liepniece-Karele I
FAU - Leja, Marcis
AU  - Leja M
FAU - Dinis-Ribeiro, Mario
AU  - Dinis-Ribeiro M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
SB  - IM
MH  - Adenocarcinoma/*pathology
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy/methods/standards
MH  - Colorimetry/methods/standards
MH  - Female
MH  - Gastric Mucosa/*pathology
MH  - Gastroscopy/*methods/*standards
MH  - Humans
MH  - Image Enhancement/methods/standards
MH  - Male
MH  - Metaplasia/pathology
MH  - Middle Aged
MH  - Precancerous Conditions/pathology
MH  - Reproducibility of Results
MH  - Risk Assessment
MH  - Sensitivity and Specificity
MH  - Stomach Neoplasms/*pathology
EDAT- 2014/06/06 06:00
MHDA- 2015/01/21 06:00
CRDT- 2014/06/06 06:00
PHST- 2014/06/06 06:00 [entrez]
PHST- 2014/06/06 06:00 [pubmed]
PHST- 2015/01/21 06:00 [medline]
AID - 00042737-201407000-00003 [pii]
AID - 10.1097/MEG.0000000000000108 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2014 Jul;26(7):704-9. doi: 
      10.1097/MEG.0000000000000108.