Application Of Linked Color Imaging Endoscope And Blue Laser Imaging Endoscope In Chronic Gastritis

Objective:First,comparing the White light imaging endoscope(WLI)and the Linked color imaging endoscope to evaluate the diagnosis of H.pylori by meta analysis.Meanwhile,evaluate the diagnosis of intestinal metaplasia on Blue laser imaging endoscope(BLI)by meta analysis.Then,explore the diagnostic value of magnifying endoscope combined with BLI,LCI and WLI in Hp and related applications of chronic gastritis.Provide evidence-based medicine to increase the detection rate of H.pylori infection.Materials and Methods:First,collecting relevant literature by searching the frequently used Chinese and English literature databases like PubMed?CNKI etc.Establish relevant standards to screen and evaluate documents and extract target indicators.Finally,statistical analysis is carried out using Meta-disc 1.4,Review manager 5.3 and STATA 15.1 software.Second,43 patients who were received the upper Upper gastrointestinal endoscope in the department of Gastroenterology Endoscopy Center,the First Affiliated Hospital of Jinan University,from November 2019 to April2020 were incorporated.First they used the white light imaging to observe the whole gastric mucosa according to standard procedure.Then switched to the LCI mode and BLI mode to judge if it was Hp infected or not.Next,according to the same sequence to observe the anturm carefully.If lesions were discovered,switching on the magnifying function to observe the microsurface(MS)and the microvascular(MV).each lesion were taken biopsy specimens for the rapid urease test(RUT)and pathological diagnosis.Collecting data to analyze the diagnostic value of Hp by calculating the sensitivity,specificity,positive prediction value and negative prediction value respectively in different mode.Results:Section 1:5 articles in which contain 583 patients and 939 lesions.For the Linked color imaging endoscope(LCI): the receiver operating characteristic curve(SROC)was summarized,and the area under the curve(AUC)was 87.57%.While for the White light imaging endoscope(WLI):the AUC of the SROC was 79.16%.Section 2:6 articles were took into account at last,which contain 788 patient and 1490 pieces of pathology.The receiver operating characteristic curve(SROC)was summarized,and the AUC of the SROC was 90%.Section3:The diagnostic value of Hp for LCI is superior than WLI and BLI.The sensitivity,specificity,positive prediction value and negative prediction value was 92.0% ?66.6%?79.3%?85.7% respectively.Meanwhile,it has a good consistency with pathology because of the kappa was 0.606.Degree of gastritis and degree of atrophy are positive correlation with different pit pattern when the BLI-ME used to observed.But it doesn't exist linear correlation between pit pattern and intestinal metaplasia as well as atypical hyperplasia.And the Hp infection rate between different type A pit pattern had statistical differences.Conclusions:Section 1:We consider the LCI to be better than the WLI in the diagnostic value of H.pylori;Section 2:Gastrointestinal metaplasia can be well diagnosed by BLI;Section 3:the blue laser imaging endoscope is a new type imaging-enhanced endoscope.The LCI is most suitable for diagnosing Hp and can get a good consistency with pathology.Different type pit pattern of anturm has positive correlation with Hp infection.The infection rate is higher in type A-2.Degree of gastritis and degree of atrophy are positive correlation with different pit pattern when the BLI-ME used to observed.However,intestinal metaplasia and atypical hyperplasia is not related with different pit pattern.And the pit pattern has poor consistency with pathology.