The Follow-up Of Gastric Low-grade Intraepithelial Neoplasia And The Application Of Narrow-band Imaging Magnifying Endoscopy In The Follow-up Of Gastric Low-grade Intraepithelial Neoplasia

Objectives To examine the feasibility of WLE and ME-NBI in discriminating EGC from LGIN.Methods This was a retrospective study in a single center.From January 2007 to December 2017,188 patients were diagnosed as LGIN through endoscopic biopsies and followed up afterwards with WLE or ME-NBI in Peking Union Medical College Hospital.We focused on lesions diagnosed as gastric cancers within one year of endoscopy,and investigated the association between the final pathological diagnosis and endoscopic characters.The diagnostic efficacy of WLE and ME-NBI were analyzed.Results 196 lesions from 188 patients were enrolled.48 lesions(24.5%)turned out to be EGC during surveillance within one year.In the univariate analysis,pathological progression significantly correlated with single lesion,lager than 1cm,no erosion,spontaneous bleeding and nodular surface.They were also independent predictive factors for pathological progression in the multivariate analysis.Pathological progression significantly correlated with demarcation line,irregular or absent MSP and irregular MVP as well(P<0.01).The sensitivity of WLE and ME-NBI for missing gastric cancer detection were 65.2%and 91.3%.Their specificity were 86.6%and 77.7%respectively.There were 14 lesions(14/16,87.5%)that could not be diagnosed using WLE able to be diagnosed with ME-NBI.On the other hand,in 4 lesions that could not be diagnosed when using ME-NBI,there were 2 lesions(50%)that could be diagnosed using conventional WLE only.Conclusion Making good use of ME-NBI for evaluating lesions diagnosed as LGIN by forceps biopsy can be helpful in reducing missing cancer rates.