Original research: THE IMPORTANCE OF NARROW-BAND IMAGING ENDOSCOPY IN THE CLASSIFICATION OF GASTRIC POLYPS

First author: Francisc Ianosi-Andreeva-Dimitrova

Coordinator(s): Professor Ecaterina Daniela Dobru , Assistant Professor Danusia Maria Onișor

Keywords: gastric polyp narrow-band imaging endoscopy

Background: The visualization of blood vessels in gastric polyps with narrow-band imaging allows the physician to evaluate the vascular pattern of the gastric tissue in real time thus allowing the early detection of neoplastic lesions, this pattern being modified in accordance with the tissue abnormality. The normal gastric mucosa displays either a coil-shaped pattern of a subepithelial capillary network without collecting venules or small round pits surrounded by honeycomb-like subepithelial capillary network with capillary venules. Fundic gland polyps have a honeycomb pattern with dense vascularity, this pattern being noticed also in hyperplastic polyps thus complicating the diagnosis. Gastric adenomas display a regular microsurface and microvascularity, changes in this respect showing a carcinoma transformation. Intestinal metaplasia is described as blue whitish raised areas. Objective: The hypothesis is that narrow-band imaging enhances the early classification of gastric polyps and the diagnosis of their premalignant or malignant status.
Material and Method: Patients with gastric polyps from Mureș County Hospital, Romania from year 2015, were included in this prospective study. The endoscopic findings were noted and analyzed.
Results: Both men and women are equally affected, the mean age for polyp development being 58 years. In more than 80% of the patients the polyps were hyperplastic, 8% of the polyps were adenomas and 6% fundic. Inflammation was present in all the hyperplastic polyp cases. One third of the aforementioned polyps displayed intestinal metaplasia. Atrophy is a factor that favors the development of gastric adenomas.
Conclusions: The use of narrow-band imaging technology in endoscopy greatly enhances the early diagnosis of dysplastic transformations in gastric mucous tissue and the classification of the gastric polyps.

Advertisements