| BackgroundGastric metaplasia(GIM)is a gastric precancerous lesions,there are a variety of endoscopic techniques can screening or assessment of intestinal metaplasia,traditional white light endoscopy(WLE)with acetic acid to enhance magnifying endoscopy(ME-AAC)have different effect to the diagnosis of intestinal metaplasia,endoscopic optical enhancement(OE)is a new kind of virtual staining endoscopy technology,but there are no relevant research,so understanding to understand this new virtual staining endoscopy technology to the value of the gastric mucosa of intestinal metaplasia has important clinical significance.Objectives1.To explore the diagnostic ability of white light endoscopy(WLE),acetic acid enhanced magnification endoscopy(ME-AAC)and optical enhanced magnification endoscopy(ME-OE)in the diagnosis of gastric mucosa and intestinal metaplasia.2.To evaluate the time required for the diagnosis of gastric mucosa and intestinal metaplasia by ME-AAC and ME-OE respectively.3.By evaluating the GIM images diagnosed by optical enhanced magnification endoscopy(ME-OE),the expert group and non-expert group analyzed the diagnostic accuracy and intra-observer and inter-observer consistency of each group and each group.MethodsChosen from August 2019 to January 2020 in xinxiang medical college affiliated 156 patients of zhengzhou central hospital behavior gastroscopy,after met inclusion criteria and exclusion criteria,for every patients gastroscopy,according to WLE,ME-OE,ME-AAC in the order to check whether there is a suspicious GIM,stomach and in the end that the existence of GIM parts for targeted biopsy in gastric antrum and stomach Angle line three random biopsies,and three kinds of endoscopy has not been found suspicious GIM,in gastric antrum,stomach Angle line three random biopsies,Any abnormal gastric lumen area is defined as the white light endoscopy(WLE)under suspicious GIM parts,after spraying with acetic acid,the stomach cavity appear white vinegar,gyrus up under the magnifying glass sample or fluffy change is defined as the acetic acid pigment under endoscopy combined magnifying endoscopy(ME-AAC)suspicious GIM parts,use zoom optical enhancement endoscopy(ME-OE)mode1 mode for suspicious areas of amplification,found that bright blue ridge(LBC)is considered to be the optical enhancement under magnifying endoscopy(ME-OE)suspicious GIM parts,with pathologic evaluation as the reference standard,The diagnostic ability of intestinal metaplasia among the three groups were compared,and the diagnosis time of ME-AAC and ME-OE were analyzed.GIM images diagnosed with ME-OE were evaluated by two experts and two non-experts,and the diagnostic accuracy and intra-observer and inter-observer consistency were analyzed.ResultsGIM was detected in 68 of 156 patients(43.6%).The accuracy of ME-OE in the diagnosis of MEG was 91.7%,followed by ME-AAC in 86.5% and WLE in 51.9%.For biopsy site,the overall diagnostic accuracy of ME-OE was higher than that of ME-AAC(P=0.011)and WLE(P<0.001).The mean time to diagnosis of ME-OE was lower than that of ME-AAC(64±7s vs 151±30s,P <0.001).The total correct rate was 79.2% for 4physicians,83.3%(83.3%,83.3%)for 2 experts,and 75%(76.7%,80%)for 2 non-experts.Finally,there was strong agreement between expert(k=0.862)and non-expert(k=0.800)observers.The internal consistency of the expert group was strong(k=0.713,k=0.724),while the internal consistency of the non-expert group was general(k=0.667,k=0.598).ConclusionsWith white light endoscopy(WLE),acetic acid,strengthen the magnifying endoscopy(ME-AAC)compared to amplify optical enhancement endoscopy(ME-OE)value to the diagnosis of intestinal metaplasia of gastric mucosa from diagnostic capacity or have more advantages on time,and whether experts or non-experts,use zoom optical enhancement endoscopy(ME-OE)in the diagnosis of intestinal metaplasia of gastric mucosa are better,especially experienced physicians for endoscopy endoscopic physicians,ME-OE is a highly efficient,convenient,time-saving endoscopic diagnosis method. |
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