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The added value of magnifying endoscopy in diagnosing patients with certain gastroesophageal reflux disease.
Adv Med Sci. 2018 Sep; 63(2):359-366.AM

Abstract

PURPOSE

In most cases gastroesophageal reflux disease proceeds without macroscopic erosions in the esophagus. We aimed to clarify if abnormalities detectable in magnifying endoscopy may offer additional diagnostic criteria for gastroesophageal reflux disease and to what histopathologic structures do they correspond.

PATIENTS/METHODS

Esophageal mucosa above and below Z-line was evaluated under x115 magnification in 67 gastroesophageal reflux disease patients (11 with erosive reflux disease, 28 with Barrett's esophagus, 28 with nonerosive reflux disease) and in 12 patients without gastroesophageal reflux disease (negative control group). Features characteristic of gastroesophageal reflux disease were specified by comparing erosive reflux disease and Barrett's esophagus patients with negative control group. Afterwards the presence of identified features were evaluated in nonerosive reflux disease group. Interobserver agreement in the recognition of the proposed criteria was rated. Biopsies collected from the mucosa above Z-line were evaluated histologically after hematoxylin and eosin staining.

RESULTS

Endoscopic lesions characteristic of gastroesophageal reflux disease were: microerosions, abnormal intrapapillary capillary loops, obscured palisade vessels, white points, big triangular indentations of Z-line and villous mucosa below Z-line. The presence of two or more of the above features indicated gastroesophageal reflux disease with 97% sensitivity and 75% specificity. Substantial interobserver agreement was achieved in evaluation of obscured palisade vessels, abnormal intrapapillary capillary loops and white points. Endoscopic lesions were correlated to histology. Lesions identified with magnifying endoscopy were helpful in discerning between negative control group and nonerosive reflux disease patients.

CONCLUSIONS

Magnifying endoscopy reveals abnormalities that can be used as additional endoscopic diagnostic criteria of gastroesophageal reflux disease.

Authors+Show Affiliations

Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland. Electronic address: jwasielica@o2.pl.Department of Pathomorphology, Medical University of Bialystok, Bialystok, Poland.Department of Pathomorphology, Medical University of Bialystok, Bialystok, Poland.Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30114679

Citation

Wasielica-Berger, Justyna, et al. "The Added Value of Magnifying Endoscopy in Diagnosing Patients With Certain Gastroesophageal Reflux Disease." Advances in Medical Sciences, vol. 63, no. 2, 2018, pp. 359-366.
Wasielica-Berger J, Kemona A, Kiśluk J, et al. The added value of magnifying endoscopy in diagnosing patients with certain gastroesophageal reflux disease. Adv Med Sci. 2018;63(2):359-366.
Wasielica-Berger, J., Kemona, A., Kiśluk, J., Świdnicka-Siergiejko, A., Rogalski, P., Chwieśko, A., Kostrzewska, M., & Dąbrowski, A. (2018). The added value of magnifying endoscopy in diagnosing patients with certain gastroesophageal reflux disease. Advances in Medical Sciences, 63(2), 359-366. https://doi.org/10.1016/j.advms.2018.04.006
Wasielica-Berger J, et al. The Added Value of Magnifying Endoscopy in Diagnosing Patients With Certain Gastroesophageal Reflux Disease. Adv Med Sci. 2018;63(2):359-366. PubMed PMID: 30114679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The added value of magnifying endoscopy in diagnosing patients with certain gastroesophageal reflux disease. AU - Wasielica-Berger,Justyna, AU - Kemona,Andrzej, AU - Kiśluk,Joanna, AU - Świdnicka-Siergiejko,Agnieszka, AU - Rogalski,Paweł, AU - Chwieśko,Adam, AU - Kostrzewska,Maja, AU - Dąbrowski,Andrzej, Y1 - 2018/08/14/ PY - 2017/08/27/received PY - 2018/04/09/revised PY - 2018/04/26/accepted PY - 2018/8/17/pubmed PY - 2019/3/9/medline PY - 2018/8/17/entrez KW - GERD KW - Histology KW - Magnifying endoscopy KW - Minimal change esophagitis KW - NERD SP - 359 EP - 366 JF - Advances in medical sciences JO - Adv Med Sci VL - 63 IS - 2 N2 - PURPOSE: In most cases gastroesophageal reflux disease proceeds without macroscopic erosions in the esophagus. We aimed to clarify if abnormalities detectable in magnifying endoscopy may offer additional diagnostic criteria for gastroesophageal reflux disease and to what histopathologic structures do they correspond. PATIENTS/METHODS: Esophageal mucosa above and below Z-line was evaluated under x115 magnification in 67 gastroesophageal reflux disease patients (11 with erosive reflux disease, 28 with Barrett's esophagus, 28 with nonerosive reflux disease) and in 12 patients without gastroesophageal reflux disease (negative control group). Features characteristic of gastroesophageal reflux disease were specified by comparing erosive reflux disease and Barrett's esophagus patients with negative control group. Afterwards the presence of identified features were evaluated in nonerosive reflux disease group. Interobserver agreement in the recognition of the proposed criteria was rated. Biopsies collected from the mucosa above Z-line were evaluated histologically after hematoxylin and eosin staining. RESULTS: Endoscopic lesions characteristic of gastroesophageal reflux disease were: microerosions, abnormal intrapapillary capillary loops, obscured palisade vessels, white points, big triangular indentations of Z-line and villous mucosa below Z-line. The presence of two or more of the above features indicated gastroesophageal reflux disease with 97% sensitivity and 75% specificity. Substantial interobserver agreement was achieved in evaluation of obscured palisade vessels, abnormal intrapapillary capillary loops and white points. Endoscopic lesions were correlated to histology. Lesions identified with magnifying endoscopy were helpful in discerning between negative control group and nonerosive reflux disease patients. CONCLUSIONS: Magnifying endoscopy reveals abnormalities that can be used as additional endoscopic diagnostic criteria of gastroesophageal reflux disease. SN - 1898-4002 UR - https://www.unboundmedicine.com/medline/citation/30114679/The_added_value_of_magnifying_endoscopy_in_diagnosing_patients_with_certain_gastroesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1896-1126(18)30066-X DB - PRIME DP - Unbound Medicine ER -