Narrow Band Imaging For Diagnosis Of Intestinal Metaplasia:A Meta-analysis

Objective : This study is to evaluate the clinical value of narrow-band imaging endoscopy in the diagnosis of gastric intestinal metaplasia.Methods:Computer search combined with manual search method were used,such as PubMed,Cochrane Library,CNKI,VIP,WanFang Data database were searched.Search terms include "narrow band imaging","intestinal metaplasia",and " gastric/stomach." The search time is from database setup to September 2018.Meta-analysis was performed using Stata12.0 software for studies that met the inclusion criteria.Results:A total of 492 medical records were included in 6 studies for meta-analysis.Results of meta-analysis showed that the sensitivity of narrow-band imaging endoscopy for the diagnosis of gastric intestinal metaplasia was 89%(95% CI = 0.83-0.93;I2 = 40%),and the specificity was 91%(95% CI =0.88-0.94;I2 = 0),the positive likelihood ratio was 10.34(95% CI = 7.49-14.29;I2 = 0),and the negative likelihood ratio was 0.12(95% CI = 0.08-0.18;I2 = 34%).The results are stable and reliable,the heterogeneity is small and the publication bias is not obvious.At the same time,we made a descriptive statistical analysis of the semiquantitative evaluation of LBC appearance and the severity of pathological intestinal metaplasia(the percentage of metaplastic glands on the entire antral or oxyntic mucosa specimens)in one of the 100 clinical cases.We found that when the pathological intestinal metaplasia was 0%,the LBC was 0 ~+.When the pathological intestinal metaplasia was less than 5%,the LBC was+~++.when the pathological intestinal metaplasia was between 5% and 45%,the LBC was 0 ~+++,and the percentage of pathological intestinal metaplasia was more than 80%,the LBC was all.Conclusion:Narrow-band endoscopic imaging technique has good sensitivity and specificity for the diagnosis of intestinal metaplasia of gastric mucosa and has good diagnostic performance.