Robles-Medranda C, Valero M, Puga-Tejada M, Oleas R, Baquerizo-Burgos J, Soria-Alcívar M, Alvarado-Escobar H, Pitanga-Lukashok H. High-definition optical magnification with digital chromoendoscopy detects gastric mucosal changes in dyspeptic-patients. World J Gastrointest Endosc 2020; 12(1): 23-32 [PMID: 31942231 DOI: 10.4253/wjge.v12.i1.23]
Corresponding Author of This Article
Carlos Robles-Medranda, MD, Professor, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Av. Abel Romeo Castillo y Av. Juan Tanca Marengo, Torre Vitalis, Mezzanine 3, Guayaquil 090505, Ecuador. carlosoakm@yahoo.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2020; 12(1): 23-32 Published online Jan 16, 2020. doi: 10.4253/wjge.v12.i1.23
High-definition optical magnification with digital chromoendoscopy detects gastric mucosal changes in dyspeptic-patients
Carlos Robles-Medranda, Manuel Valero, Miguel Puga-Tejada, Roberto Oleas, Jorge Baquerizo-Burgos, Miguel Soria-Alcívar, Haydee Alvarado-Escobar, Hannah Pitanga-Lukashok
Carlos Robles-Medranda, Manuel Valero, Miguel Puga-Tejada, Roberto Oleas, Jorge Baquerizo-Burgos, Miguel Soria-Alcívar, Haydee Alvarado-Escobar, Hannah Pitanga-Lukashok, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil 090505, Ecuador
Author contributions: Robles-Medranda C and Pitanga-Lukashok H designed the study; Robles-Medranda C, Valero M, Soria-Alcívar M and Alvarado-Escobar H performed the research; Puga-Tejada M analyzed the data; Valero M, Oleas R and Baquerizo-Burgos J wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Instituto Ecuatoriano de Enfermedades Digestivas Institutional Review Board.
Clinical trial registration statement: This study is registered on clinical trials.gov under the code NCT02597517.
Informed consent statement: Informed written consent was provided from all study participants or their legal guardian prior to study enrollment.
Conflict-of-interest statement: Robles-Medranda C is a key opinion leader for Pentax Medial and Boston Scientific. The other authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Carlos Robles-Medranda, MD, Professor, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Av. Abel Romeo Castillo y Av. Juan Tanca Marengo, Torre Vitalis, Mezzanine 3, Guayaquil 090505, Ecuador. carlosoakm@yahoo.es
Received: June 28, 2019 Peer-review started: June 29, 2019 First decision: August 2, 2019 Revised: August 13, 2019 Accepted: November 18, 2019 Article in press: November 18, 2019 Published online: January 16, 2020 Processing time: 172 Days and 18 Hours
ARTICLE HIGHLIGHTS
Research background
Helicobacter pylori (H. pylori) infection and atrophic gastritis are linked to gastric carcinogenesis. The endoscopic diagnosis of H. pylori infection and gastric atrophy is challenging, requiring histological confirmation; however, sampling errors might occur.
Research motivation
Digital chromoendoscopy with optical magnification improved the identification of mucosal superficial and vascular patterns in the gastric mucosa and might provide a more accurate endoscopic visual impression of the gastric mucosa.
Research objectives
The main objective of the study was to evaluate digital chromoendoscopy with optical magnification for the diagnosis of normal gastric mucosa, H. pylori associated gastritis and atrophic gastritis.
Research methods
This was a cross-sectional, nonrandomized, single-center study in which consecutive patients with functional dyspepsia were evaluated via esophagogastroduodenoscopy using a high definition endoscope with digital chromoendoscopy and optical magnification for the endoscopic diagnosis of H. pylori associated gastritis and atrophic gastritis. The endoscopic visual impression was compared to H. pylori stool antigen test and histological analysis.
Research results
We described a high sensitivity and accuracy for predicting normal gastric mucosa and H. pylori associated gastritis, with a high inter and intraobserver agreement. Atrophic gastritis was detected with a low sensitivity, and further studies are required to determine if endoscopic diagnosis of atrophic gastritis is feasible.
Research conclusions
In our study, esophagogastroduodenoscopy with digital chromoendoscopy and optical magnification enable the identification of histological changes in the gastric mucosa of consecutive patients with functional dyspepsia.
Research perspectives
We encourage a randomized multicenter trial evaluating high definition white light endoscopy versus digital chromoendoscopy with optical magnification for the evaluation of the gastric mucosa of dyspeptic patients, in order to determine the clinical practice applicability of these techniques. Further studies are needed to determine if endoscopic diagnosis of atrophic gastritis is feasible.
