Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia

Table 1 Endoscopic criteria using narrow-band imaging for diagnosis of gastric intestinal metaplasia

Ref.	Year	Endoscopy mode	Diagnostic criteria	Concordance with histopathology
				Sensitivity	Specificity	Accuracy
Pimentel-Nunes et al[37]	2012	NBI	Regular tubulovillous/ridge glandular pattern	90%	81%	84%
Saka et al[36]	2015	M-NBI	Tubular/granular mucosa with LBC or WOS	N/A	N/A	69.1-72.7%1
Pimentel-Nunes et al[39]	2016	NBI	Regular tubulovillous/ridge glandular pattern	87%	97%	94%
Buxbaum et al[41]	2017	NBI	Tubulovillous/ridge pattern and/or LBC	N/A	N/A	53-65%2
Esposito et al[40]	2019	NBI	Regular tubulovillous/ridge glandular pattern	89.4%	94.6%	N/A
An et al[34]	2012	M-NBI	MTB and/or LBC	72.1-100%3	66.0-96.0%3	81.7-84.9%3
Savarino et al[33]	2013	M-NBI	LBC	80%	96%	93%
Kanemitsu et al[35]	2017	M-NBI	WOS and/or LBC	87.5%	93.8%	90.0%

¹Concordance rate between the M-NBI and histopathology was 69.1% for the antrum and 72.7% for the corpus.

²Diagnostic yield per-patient and per-site was 65% and 53%, respectively.

³MTB and LBC had sensitivities, specificities, and accuracy of 100/72.1%, 66.0/96.0%, and 81.7/84.9%, respectively. NBI: Narrow-band imaging; M-NBI: Magnifying narrow-band imaging; LBC: Light blue crest; WOS: White opaque substance; MTB: Marginal turbid band; N/A: Not applicable.

Table 2 Diagnostic performance of narrow-band imaging with magnification for early gastric cancer

Ref.	Year	Endoscopic criteria of NBI with magnification	NBI with magnification (vs white light imaging)
			Sensitivity	Specificity	Accuracy
Yao et al[52]	2007	Irregular microvascular pattern	92.9%	99.3%	98.7%
Ezoe et al[53]	2010	Demarcation line	70.0% (33.3%1)	88.8% (66.6%1)	78.9% (43.8%1)
		Irregular microvascular pattern
Kato et al[58]	2010	Disappearance of fine mucosal structure	92.9% (42.9%)	94.7% (61.0%)	N/A
		Microvascular dilation
		Microvascular heterogeneity in shape
Yamada et al[54]	2014	Demarcation line	95% (40%2)	97% (68%2)	97% (65%2)
		Irregular microvascular pattern
Yao et al[56]	2014	VS classification	85.7%	99.4%	98.1%
Fugiwara et al[57]	2015	VS classification	78.0% (43.7%3)	92.9% (81.6%3)	88.3% (69.9%3)
Kanesaka et al[59]	2015	Microvascular dilation	25%	90%	83%
		Microvascular tortuosity	55%	24%	28%
		Difference in caliber	13%	99%	89%
		Variation in shape	70%	95%	92%

¹Diagnostic sensitivity, specificity, and accuracy using white-light endoscopy with magnification.

²Endoscopic criteria of white-light endoscopy for gastric cancer were an irregular margin and a spiny depressed area.

³Diagnostic sensitivity, specificity, and accuracy using chromoendoscopy with indigo carmine. NBI: Narrow-band imaging; VS: Vessel plus surface; N/A: Not applicable.

Table 3 Determination of the horizontal extent of early gastric cancer by magnifying narrow-band imaging

Ref.	Study design	Lesion (n)	Pathology	Diagnostic accuracy	P value
Kiyotoki et al[61]	Comparative study between CE and M-NBI	EGC (70), adenoma (13)	ESD	77.8% vs 97.4%	0.009
	Marking dots were placed on the tumor margins
Nagahama et al[63]	M-NBI for unclear margins by CE	EGC (350)	ESD	81.1% → 94.8%	< 0.001
Uchita et al[64]	Combination of CE and M-NBI	EGC (161)	ESD	72.7% → 98.1%	< 0.001
Asada-Hirayama et al[62]	Comparative study between CE and M-NBI	EGC (109)	ESD	75.9% vs 89.4%	0.007
	Oral and anal tumor margins of the same lesion
Nagahama et al[66]	Comparative study between CE and M-NBI	EGC (343)	Biopsy	85.7% vs 88.0%	0.63
	Biopsies outside and inside the tumor margins
Horii et al[65]	Non-comparative study using M-NBI only	EGC (330)	Biopsy, ESD	96.7%-97.9%	N/A

CE: Chromoendoscopy; M-NBI: Magnifying narrow-band imaging; EGC: Early gastric cancer; ESD: Endoscopic submucosal dissection; N/A: Not applicable.