Narrow-band imaging with magnification in Barrett's esophagus: validation of a simplified grading system of mucosal morphology patterns against histology
| Autor: | Kenshi Yao, George K. Anagnostopoulos, Christopher J. Hawkey, Philip Kaye, Klara Garsed, Rajvinder Singh, Anthony Shonde, Haris Karageorgiou, Paul J. Fortun, Krish Ragunath |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Magnification Sensitivity and Specificity Cohort Studies Barrett Esophagus Risk Factors medicine Confidence Intervals Image Processing Computer-Assisted Humans Prospective Studies Esophagus Aged Probability Aged 80 and over Observer Variation Reproducibility Mucous Membrane business.industry Esophageal disease Biopsy Needle Gastroenterology Intestinal metaplasia Reproducibility of Results Middle Aged medicine.disease Image Enhancement Immunohistochemistry medicine.anatomical_structure Dysplasia Barrett's esophagus Female Esophagoscopy business Nuclear medicine Precancerous Conditions Kappa |
| Zdroj: | Endoscopy. 40(6) |
| ISSN: | 1438-8812 |
| Popis: | Background and study aims Validation of a simplified classification of mucosal morphology in prediction of histology in Barrett's esophagus using narrow-band imaging with magnification (NBI-Z) and assessing its reproducibility by endoscopists experienced in the use of NBI (NBI-experts) and by endoscopists who were new to NBI (non-NBI-experts). Patients and methods In a prospective cohort study of 109 patients with Barrett's esophagus at a single tertiary referral center, mucosal patterns visualized in Barrett's esophagus on NBI-Z were classified into four easily distinguishable types: A, round pits with regular microvasculature; B, villous/ridge pits with regular microvasculature; C, absent pits with regular microvasculature; D, distorted pits with irregular microvasculature. The NBI-Z grading was compared with the final histopathological diagnosis, and positive (PPV) and negative predictive values (NPV) were calculated. The reproducibility of the grading was then assessed by NBI-expert and non-NBI-expert endoscopists, and interobserver and intraobserver agreement were calculated using kappa statistics. Results Per-biopsy analysis: In 903 out of 1021 distinct areas (87.9%) the NBI-Z grading corresponded to the histological diagnosis. Per-patient analysis: The PPV and NPV for type A pattern (columnar mucosa without intestinal metaplasia) were 100% and 97% respectively; for types B and C (intestinal metaplasia) they were 88% and 91% respectively, and for type D (high-grade dysplasia) 81% and 99% respectively. Inter- and intraobserver agreement: The mean kappa values in assessing the various patterns were 0.71 and 0.87 in the non-expert group; 0.78 and 0.91 in the expert group. Conclusions This study has validated a simplified classification of the various morphologic patterns visualized in Barrett's esophagus and confirmed its reproducibility when used by NBI-expert and non-NBI-expert endoscopists. |
| Databáze: | OpenAIRE |
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