Efficacy of a Third-Generation High-Vision Ultrathin Endoscope for Evaluating Gastric Atrophy and Intestinal Metaplasia in Helicobacter pylori-Eradicated Patients

Junichi Uematsu; Mitsushige Sugimoto; Mariko Hamada; Eri Iwata; Ryota Niikura; Naoyoshi Nagata; Masakatsu Fukuzawa; Takao Itoi; Takashi Kawai

doi:10.3390/jcm11082198

Efficacy of a Third-Generation High-Vision Ultrathin Endoscope for Evaluating Gastric Atrophy and Intestinal Metaplasia in Helicobacter pylori-Eradicated Patients

J Clin Med. 2022 Apr 14;11(8):2198. doi: 10.3390/jcm11082198.

Authors

Junichi Uematsu¹, Mitsushige Sugimoto¹, Mariko Hamada¹, Eri Iwata¹, Ryota Niikura¹, Naoyoshi Nagata¹, Masakatsu Fukuzawa², Takao Itoi², Takashi Kawai¹

Affiliations

¹ Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan.
² Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan.

Abstract

Background: Image-enhanced endoscopy methods such as narrow-band imaging (NBI) are advantageous over white-light imaging (WLI) for detecting gastric atrophy, intestinal metaplasia, and cancer. Although new third-generation high-vision ultrathin endoscopes improve image quality and resolution over second-generation endoscopes, it is unclear whether the former also enhances color differences surrounding atrophy and intestinal metaplasia for endoscopic detection. We compared the efficacy of a new third-generation ultrathin endoscope and an older second-generation endoscope.

Methods: We enrolled 50 Helicobacter pylori-eradicated patients who underwent transnasal endoscopy with a second-generation and third-generation endoscope (GIF-290N and GIF-1200N, respectively) in our retrospective study. Color differences based on the International Commission on Illumination 1976 (L*, a*, b*) color space were compared between second-generation and third-generation high-vision endoscopes.

Results: Color differences surrounding atrophy produced by NBI on the GIF-1200N endoscope were significantly greater than those on GIF-290N (19.2 ± 8.5 vs. 14.4 ± 6.2, p = 0.001). In contrast, color differences surrounding intestinal metaplasia using both WLI and NBI were similar on GIF-1200N and GIF-290N endoscopes. NBI was advantageous over WLI for detecting intestinal metaplasia on both endoscopes.

Conclusions: NBI using a third-generation ultrathin endoscope produced significantly greater color differences surrounding atrophy and intestinal metaplasia in H. pylori-eradicated patients compared with WLI.

Keywords: Kyoto classification of gastritis; gastric atrophy and intestinal metaplasia; narrow-band imaging; third-generation ultrathin endoscope; transnasal endoscopy.