Diagnostic Value Of Dual-focal Endoscopy Combined With Narrow-band Imaging For Verrucous Protuberant Lesions Of Gastric Mucosa

Object: By applying the dual focus endoscope combined with narrow-band imaging(DF-NBI)to observe the gastric mucosa verrucous protuberant lesions gastric pit shape and clarity,and pathological changes were compared,discussed the method of gastric mucosa severity verrucous protuberant lesions,especially intestinal metaplasia and intraepithelial neoplasia precancerous condition and the feasibility of the diagnosis of precancerous lesions.Methods: The verrucous protuberant lesions of gastric mucosa were found by gastroscopy in the Endoscope Center of our hospital from Nov.2019 to Sep.2020.Ordinary Narrow-band imaging(NBI)mode and near focus mode(NFM)combined with NBI were used to observe the clarity and shape of gastric pit,and the images were recorded.Targeted biopsy was performed immediately at the lesion,and the difference in the clarity of gastric pit between the two methods was analyzed.The morphology of gastric pits was classified with reference to the studies of Huang Yonghui et al.and Zhu Bingliang et al.,and the corresponding relationship between gastric pit and pathological features were analyzed.Results: A total of 50 patients(53 lesions)were enrolled in the experiment,including50 cases located at gastric antrum and 3 at gastric angles.the ordinary NBI images were94.3% unclear and 5.7% clear,while the NBI+NFM images were 3.8% of cases unclear and 96.2% are clear.The two modes have significant statistical differences in image clarity(p <0.05).Type Ⅰ pit is linear reticular,77.8% is chronic superficial inflammation,type Ⅱ is plaque and grid,54.5% is chronic gastritis,31.8% is atrophic inflammation,type Ⅲ is villous,30.0% is intestinal metaplasia,65% is low-grade intraepithelial neoplasia,type IV is 100% high-grade intraepithelial neoplasia.According to statistical analysis,the rank correlation coefficient was 0.834(p < 0.05),and the difference was statistically significant.Conclusion:(1)Compared with conventional NBI,NBI+NFM of dual focal length endoscopy is more clearly identify the morphology of the diseased gastric pits.(2)The morphology of gastric pit in NBI+NFM mode was also correlated with pathological diagnosis.TypeⅠand Ⅱgastric pit were more common in non-neoplastic lesions.TypeⅢ and Ⅳ gastric pit showed LGIN or above pathological results in different degrees.It is of great help to judge the nature of verrucous protuberant lesions of gastric mucosa under dual focus endoscope,and to identify precancerous lesions or early gastric cancer and target accurate biopsy.