Precancerous Risk Assessment of the Gastric Atrophy by Tri-modal Endoscopy
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 7
Abstract
Background / Aims: Gastritis staging and detection of pre-neoplastic gastric mucosal changes based on the histology of biopsy specimen imposes a considerable burden on endoscopist and pathologist. Therefore, we attempted to evaluate whether gastritis staging system based on the using of conventional highresolution white light endoscopy(WLE), Auto fluorescence imaging(AFI),and narrow band imaging(NBI) is equivalent to that determined by histopathology. Methods: This study included 63 egyptian patients who were diagnosed with chronic gastritis. The lesser curvature of the antrum (2 cm from the pyloric ring) and the lesser curvature of the lower body (4 cm from the angle) were examined in consecutive order first by high resolution WLE followed by AFI and finally by NBI. Two endoscopic biopsies were taken from gastric antrum and lower gastric body for histopathological assessment of H. Pylori infestation, gastric atrophy and intestinal metaplasia (IM).The lower gastric body atrophy was graded according to OLIGA scoring system (Operative Link for Gastritis Assessment) . Additionally, the presence or absence of IM was examined in both lower gastric body and antrum. Results: By means of WLE and AFI, the patients were found to have no, mild, moderate and severe gastric atrophy in 8(16%), 18(36%), 8(16%), and 16(32%) respectively. Furthermore, Gastric atrophy was detected in all patients by NBI with mild, moderate and severe atrophy in 15(30%), 24(48%) and 11(22%) respectively. as a result of histopathological assessment, 12(24%), 34(68%), and 4(8%) had scores 1, 2 and 3 by OLIGA scoring systems respectively. in view of scoring system of gastric atrophy and intestinal metaplasia, New staging system for gastritis risk assessment was correctly identified Furthermore, Gastric cancer risk stages were recognized and the degree of correspondence on the basis of NBI and combined WLE , AFI on one hand and histopathology on the other hand were 80% and 68%. Conclusion: This study demonstrates that staging of premalignant gastric lesions with conventional NBI has better correspondence with histopathology compared with WLE and AFI and can be used for screening early malignancies of the stomach .
Authors and Affiliations
Fathi Ghamry Abdelrazek
Keywords
Related Articles
- EP ID EP527081
- DOI -
- Views 89
- Downloads 0
Serum Vascular Endothelial Growth Factor in Children with Beta Thalassemia Major
Introduction: Beta-thalassemia major is an autosomal recessive hereditary anemia; patients frequently end up with iron overload because of hemolysis and repeated blood transfusion. Treatment with iron chelating therapy i...
Comparison of the Efficacy of Clonidine and Dexemedetomidine Infusions Administered Preoperatively for Attenuation of the Hemodynamic Response Following Laryngoscopy and Endotracheal Intubation in a Placebo-Controlled Study
It is well established that laryngoscopy and endotracheal intubation invariably cause haemodynamic changes associated with increased heart rate, increased blood pressure and occasional disturbance in cardiac rhythm. Thes...
To evaluate the effectiveness of structured teaching program of knowledge and practice regarding “First Aid” among internship students of Sumandeep Nursing College
Background: Nursing management of the patient is based upon highly developed nursing assessment and clinical reasoning of skills. The nurse must know about the parameters used for First Aid, proper technique for assessme...
Levels of Hemoglobin, ESR, Iron & TIBC in Rheumatoid Arthritis Patients Compared with Normal Individuals
Rheumatoid Arthritis is a chronic multisystem disease of unknown etiology. One of the most common extraarticular features of rheumatoid arthritis is anemia. Iron plays a potential role in oxidative stress mediated injuri...
The Prevalence of Shigella and Enterotoxigenic E. Coli Infection amongst Patients Attending a General Hospital, North Bank Makurdi Nigeria
The prevalence of Enterotoxigenic E. coli and Shigella spp infection was conducted at General Hospital Makurdi, Benue State, Nigeria. One hundred and eight (108) fecal specimens from consenting clinically diagnosed patie...