Evaluation of Minimal Change Lesions Using Linked Color Imaging in Patients With Nonerosive Reflux Esophagitis - PubMed (original) (raw)
Evaluation of Minimal Change Lesions Using Linked Color Imaging in Patients With Nonerosive Reflux Esophagitis
Ni-Na Zhang et al. J Clin Gastroenterol. 2022 May-Jun.
Abstract
Background and aims: High prevalence of minimal change lesion (MCL) in nonerosive reflux esophagitis (NERD) patients is commonly recognized by many endoscopists. However, it is difficult to detect MCL with conventional white-light imaging (WLI) endoscopy. Linked color imaging (LCI), a novel image-enhanced endoscopy technology with strong, unique color enhancement, is used for easy recognition of early gastric cancer and detection of Helicobacter pylori infection. The aim of the study was to compare the efficacy of LCI and WLI endoscopy in evaluating MCL in patients with NER.
Materials and methods: Forty-one patients with NERD and 38 subjects with nongastroesophageal reflux disease (non-GERD) were recruited in this study between August 2017 and July 2018. During upper gastrointestinal endoscopy, the distal 5 cm of the esophageal mucosal morphology at the squamocolumnar junction was visualized using WLI followed by LCI. MCL was defined as areas of erythema, blurring of the Z-line, friability, decreased vascularity, white turbid discoloration, and edema or accentuation of the mucosal folds. Three experienced endoscopists evaluated the color patterns for MCL on WLI images and on WLI combined with LCI images in both groups. A biopsy was taken 2 cm above the esophagogastric junction. Histologic slides were scored by a pathologist in a blinded manner.
Results: The proportion of MCL was higher in the patients with NERD (70.7%, 29/41) than in patients with non-GERD (39.5%, 15/38) using WLI combined with LCI. In 12 patients with NERD, both WLI and LCI showed normal mucosa. The MCL detection rate was significantly higher when using WLI combined with LCI than when using WLI (70.7% vs. 51.2%, P=0.039) in patients with NERD. The histopathologic score of MCL (+) was significantly higher than that of MCL (-) patients in both the NERD group (4.59±0.32 vs. 2.36±0.34, P<0.01) and the non-GERD group (3.47±0.50 vs. 2.00±0.28, P<0.01). The intraobserver reproducibility levels and interobserver agreement were better with LCI than with WLI alone.
Conclusions: Frequency of MCL was higher in patients with NERD than in those with non-GERD. MCL can be identified by using WLI combined with LCI in patients with NERD. By enhancing endoscopic images, LCI is more sensitive in detecting MCL compared with WLI.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Similar articles
- Linked color imaging improves visibility of reflux esophagitis.
Takeda T, Asaoka D, Abe D, Suzuki M, Nakagawa Y, Sasaki H, Inami Y, Ikemura M, Utsunomiya H, Oki S, Suzuki N, Ikeda A, Yatagai N, Komori H, Akazawa Y, Matsumoto K, Ueda K, Ueyama H, Shimada Y, Matsumoto K, Hojo M, Osada T, Nojiri S, Nagahara A. Takeda T, et al. BMC Gastroenterol. 2020 Oct 27;20(1):356. doi: 10.1186/s12876-020-01511-9. BMC Gastroenterol. 2020. PMID: 33109095 Free PMC article. - Linked color imaging improves detection of minimal change esophagitis in non-erosive reflux esophagitis patients.
Deng P, Min M, Dong T, Bi Y, Tang A, Liu Y. Deng P, et al. Endosc Int Open. 2018 Oct;6(10):E1177-E1183. doi: 10.1055/a-0602-3997. Epub 2018 Oct 8. Endosc Int Open. 2018. PMID: 30302374 Free PMC article. - Inter-observer variability of experts and trainees for the diagnosis of reflux esophagitis: Comparison of linked color imaging, blue laser imaging, and white light imaging.
Lee SP, Kae SH, Jang HJ, Koh DH, Jung ES. Lee SP, et al. J Dig Dis. 2021 Jul;22(7):425-432. doi: 10.1111/1751-2980.13023. Epub 2021 Jun 17. J Dig Dis. 2021. PMID: 34036751 - The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis.
Lee JG, Yoo IK, Yeniova AO, Lee SP; Research Group for Endoscopic Imaging of Korean Society of Gastrointestinal Endoscopy. Lee JG, et al. Gut Liver. 2024 May 15;18(3):444-456. doi: 10.5009/gnl230244. Epub 2023 Oct 6. Gut Liver. 2024. PMID: 37800315 Free PMC article. Review. - Current status and future perspective of linked color imaging for gastric cancer screening: a literature review.
Yashima K, Onoyama T, Kurumi H, Takeda Y, Yoshida A, Kawaguchi K, Yamaguchi N, Isomoto H. Yashima K, et al. J Gastroenterol. 2023 Jan;58(1):1-13. doi: 10.1007/s00535-022-01934-z. Epub 2022 Oct 26. J Gastroenterol. 2023. PMID: 36287268 Free PMC article. Review.
Cited by
- Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances.
Abe Y, Sasaki Y, Yagi M, Mizumoto N, Onozato Y, Umehara M, Ueno Y. Abe Y, et al. Diagnostics (Basel). 2022 Dec 16;12(12):3202. doi: 10.3390/diagnostics12123202. Diagnostics (Basel). 2022. PMID: 36553209 Free PMC article. Review. - Linked color imaging improves the diagnostic accuracy of eosinophilic esophagitis.
Abe Y, Sasaki Y, Yagi M, Mizumoto N, Onozato Y, Kon T, Shoji M, Sakuta K, Sakai T, Umehara M, Ito M, Nakamura S, Tsuchida H, Ueno Y. Abe Y, et al. DEN Open. 2022 Jul 25;3(1):e146. doi: 10.1002/deo2.146. eCollection 2023 Apr. DEN Open. 2022. PMID: 35898847 Free PMC article. - Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review.
Wang S, Shen L, Luo H. Wang S, et al. Therap Adv Gastroenterol. 2021 Jul 6;14:17562848211025925. doi: 10.1177/17562848211025925. eCollection 2021. Therap Adv Gastroenterol. 2021. PMID: 34285717 Free PMC article.
References
- Wang C, Hunt RH. Precise role of acid in nonerosive reflux disease. Digestion. 2008;78(suppl 1):31–41.
- Tack J, Caenepeel P, Arts J, et al. Prevalence of acid reflux in functional dyspepsia and its association with symptom profile. Gut. 2005;54:1370–1376.
- Chey WD. Endoscopy-negative reflux disease: concepts and clinical practice. Am J Med. 2004;117(suppl 5A):36S–43S.
- Robles-Medranda C, Valero M, Soria-Alcivar M, et al. Detection of minimal mucosal esophageal lesions in non-erosive gastroesophageal reflux disease using optical enhancement plus optical magnification. Endosc Int Open. 2019;7:E979–E986.
- Kim MS, Choi SR, Roh MH, et al. Efficacy of I-scan endoscopy in the diagnosis of gastroesophageal reflux disease with minimal change. Clin Endosc. 2011;44:27–32.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical