2015, Number 2
Rev Hosp Jua Mex 2015; 82 (2)
Cerna-Cardona J, Manrique MA, Hernández-Velázquez NN, Gómez-Peña-Alfaro NS, Pérez-Valle E, Pérez-Corona T, Cortés-Malagón EM, Peñavera-Hernández JR, Chávez-García MÁ
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ABSTRACTObjective. To establish the mucosal and vascular patterns using high definition endoscopy with i-Scan for assessing the severity of chronic gastritis. Material and methods. Gastric mucosal patterns were assessed (antral and body region) using i-Scan 2 with endoscopic magnification. The patterns were classified into 5 types. The study included a total of 42 patients with endoscopic diagnosis of chronic gastritis by conventional endoscopy. Results. 50 patients were recruited and 8 were excluded. The crypts patterns prevalence in the participants was: 17 (40.4%) type I, 19 (45.2%) type II, 4 (9.5%) type III, 1 (2.3%) type IV and V. H. pylori was diagnosed in 64.5% of patients by histopathology using hematoxylin-eosin and in 100% of the samples using polymerase chain reaction. The Kappa value calculated to establish the correlation between crypts patterns for i-Scan and chronic gastritis histopathology was -036, 0.22, 0.08, 0.19, 0.19 for crypt patterns I, II, III, IV, V respectively. Crypts patterns were significantly associated with all histological gastritis parameters: chronic inflammation (variance 0.53, 95%, p ‹ 0.03), atrophy (variance 0.05, 95%, p ‹ 0.23); intestinal metaplasia (variance 0.2, 95%, p ‹ 0.09), low-grade dysplasia (variance 0.13, 95%, p ‹ 0.08); cancer (variance 0.5, 95%, p ‹ 0.06). i-Scan 2 sensitivity, specificity, PPV, NPV to predict gastric cancer were 100%, 100%, 100%, 100% respectively. The calculated Kappa value between the i-Scan 2 and histopathology was 1 to 95% CI. Conclusions. Although digital enhancement improves the image quality of magnification endoscopy, its increased diagnostic value appears to be limited.