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A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease.
Gastroenterology. 2007 Aug; 133(2):454-64; quiz 674.G

Abstract

BACKGROUND AND AIMS

Narrow band imaging (NBI) endoscopy system enhances visualization of microvasculature and mucosal patterns. This study assessed the utility of NBI in patients with gastroesophageal reflux disease (GERD) symptoms.

METHODS

Patients with and without GERD symptoms completed 2 validated GERD questionnaires prior to enrollment. The distal esophagus was examined by standard white light endoscopy followed by NBI. The features seen only by NBI were compared between GERD patients and controls.

RESULTS

Overall, 80 patients (50 GERD, 30 controls) were eligible for final analysis (mean age, 58.4 years; males, 93.7%; white, 82.5%). A significantly higher proportion of patients with GERD had increased number (OR, 12.6; 95% CI: 3.7-42; P < .0001), dilatation (OR, 20; 95% CI: 6.1-65.3; P < .0001), tortuosity of intrapapillary capillary loops (IPCLs) (OR, 6.9; 95% CI: 2.5-19; P < .0001), presence of microerosions (P < .0001), and increased vascularity at the squamocolumnar junction (OR, 9.3; 95% CI: 1.9-43.6; P = .001) compared with controls. On multivariate analysis, increased number (OR, 5.5; 95% CI: 1.4-21.6) and dilatation (OR, 11.3; 95% CI: 3.2-39.9) of IPCLs were the best predictors for diagnosing GERD. The maximum, minimum, and average number of IPCLs/field were significantly greater in the GERD group compared with controls (P < .0001). Although the interobserver agreement for the various NBI findings was very good, the intraobserver agreement was modest.

CONCLUSIONS

NBI endoscopy may represent a significant improvement over standard endoscopy for the diagnosis of GERD. These preliminary findings including inter- and intraobserver agreement need to be evaluated in future prospective, controlled, and blinded GERD trials.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Missouri 64128-2295, USA. psharma@kumc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17681166

Citation

Sharma, Prateek, et al. "A Feasibility Trial of Narrow Band Imaging Endoscopy in Patients With Gastroesophageal Reflux Disease." Gastroenterology, vol. 133, no. 2, 2007, pp. 454-64; quiz 674.
Sharma P, Wani S, Bansal A, et al. A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. Gastroenterology. 2007;133(2):454-64; quiz 674.
Sharma, P., Wani, S., Bansal, A., Hall, S., Puli, S., Mathur, S., & Rastogi, A. (2007). A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. Gastroenterology, 133(2), 454-64; quiz 674.
Sharma P, et al. A Feasibility Trial of Narrow Band Imaging Endoscopy in Patients With Gastroesophageal Reflux Disease. Gastroenterology. 2007;133(2):454-64; quiz 674. PubMed PMID: 17681166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A feasibility trial of narrow band imaging endoscopy in patients with gastroesophageal reflux disease. AU - Sharma,Prateek, AU - Wani,Sachin, AU - Bansal,Ajay, AU - Hall,Sandra, AU - Puli,Srinivas, AU - Mathur,Sharad, AU - Rastogi,Amit, Y1 - 2007/06/08/ PY - 2006/09/26/received PY - 2007/05/10/accepted PY - 2007/8/8/pubmed PY - 2007/9/7/medline PY - 2007/8/8/entrez SP - 454-64; quiz 674 JF - Gastroenterology JO - Gastroenterology VL - 133 IS - 2 N2 - BACKGROUND AND AIMS: Narrow band imaging (NBI) endoscopy system enhances visualization of microvasculature and mucosal patterns. This study assessed the utility of NBI in patients with gastroesophageal reflux disease (GERD) symptoms. METHODS: Patients with and without GERD symptoms completed 2 validated GERD questionnaires prior to enrollment. The distal esophagus was examined by standard white light endoscopy followed by NBI. The features seen only by NBI were compared between GERD patients and controls. RESULTS: Overall, 80 patients (50 GERD, 30 controls) were eligible for final analysis (mean age, 58.4 years; males, 93.7%; white, 82.5%). A significantly higher proportion of patients with GERD had increased number (OR, 12.6; 95% CI: 3.7-42; P < .0001), dilatation (OR, 20; 95% CI: 6.1-65.3; P < .0001), tortuosity of intrapapillary capillary loops (IPCLs) (OR, 6.9; 95% CI: 2.5-19; P < .0001), presence of microerosions (P < .0001), and increased vascularity at the squamocolumnar junction (OR, 9.3; 95% CI: 1.9-43.6; P = .001) compared with controls. On multivariate analysis, increased number (OR, 5.5; 95% CI: 1.4-21.6) and dilatation (OR, 11.3; 95% CI: 3.2-39.9) of IPCLs were the best predictors for diagnosing GERD. The maximum, minimum, and average number of IPCLs/field were significantly greater in the GERD group compared with controls (P < .0001). Although the interobserver agreement for the various NBI findings was very good, the intraobserver agreement was modest. CONCLUSIONS: NBI endoscopy may represent a significant improvement over standard endoscopy for the diagnosis of GERD. These preliminary findings including inter- and intraobserver agreement need to be evaluated in future prospective, controlled, and blinded GERD trials. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/17681166/A_feasibility_trial_of_narrow_band_imaging_endoscopy_in_patients_with_gastroesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(07)01145-6 DB - PRIME DP - Unbound Medicine ER -