Standard magnifying narrow-band imaging endoscopy for diagnosis of infection and gastric precancerous conditions.

Background: Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer. However, there are no comparative data on the utility of standard and magnifying narrow-band imaging (M-NBI) endoscopy for diagnosing () infection, gastric atrophy, and intestinal metaplasia.

Aim: To compare the diagnostic performance of standard and M-NBI endoscopy for gastritis and precancerous conditions.

Methods: In 254 patients, standard endoscopy findings were classified into mosaic-like appearance (type A), diffuse homogenous redness (type B), and irregular redness with groove (type C). Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci (type Z-1), more dilated and linear pits without sulci (type Z-2), and loss of gastric pits with coiled vessels (type Z-3).

Results: The diagnostic accuracy of standard and M-NBI endoscopy for gastritis was 93.3% and 96.1%, respectively. Regarding gastric precancerous conditions, the accuracy of standard and M-NBI endoscopy was 72.0% 72.6% for moderate to severe atrophy, and 61.7% . 61.1% for intestinal metaplasia in the corpus, respectively. Compared to type A and Z-1, types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy [odds ratio (OR) = 5.56 and 8.67] and serum pepsinogen I/II ratio of ≤ 3 (OR = 4.48 and 5.69).

Conclusion: Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of gastritis and precancerous conditions.