In vivo gastric mucosal histopathology using endocytoscopy

Hiroki Sato, Showa University Yokohama Northern Hospital
Haruhiro Inoue, Showa University Yokohama Northern Hospital
Haruo Ikeda, Showa University Yokohama Northern Hospital
Chiaki Sato, Showa University Yokohama Northern Hospital
Chainarong Phlanusittepha, Showa University Yokohama Northern Hospital
Bu'hussain Hayee, King's College Hospital NHS Foundation Trust
Esperanza Grace R. Santi, Salle University Medical Center
Yasutoshi Kobayashi, Abe Internal Medicine Clinic
Shin Ei Kudo, Showa University Yokohama Northern Hospital

Abstract

AIM: To study the ability of endocytoscopy to identify normal gastric mucosa and to exclude Helicobacter pylori (H. pylori) infection. METHODS: Endocytoscopic examination of the gastric corpus and antrum was performed in 70 consecutive patients. Target biopsy specimens were also obtained from the assessed region and multiple H. pylori tests were performed. The normal endocytoscopy patterns of the corpus and antrum were divided into the normal pit-dominant type (n-Pit) or the normal papilladominant type (n-Pap), respectively characterized as either regular pits with capillary networks or round, smooth papillary structures with spiral capillaries. On the other hand, normal mucosa was defined as mucosa not demonstrating histological abnormalities, including inflammation and atrophy. RESULTS: The sensitivity and specificity of n-Pit for normal mucosa in the gastric corpus were 94.4% and 97.1%, respectively, whereas those of n-Pap for normal mucosa in the antrum were 92.0% and 86.7%, respectively. The positive predictive values of n-Pit and n-Pap for H. pylori-negative tissue were 88.6% and 93.1%, respectively, and their negative predictive values for H. pylori-negative tissues were 42.9% and 41.5%, respectively. The inter-observer agreement for determining n-Pit and n-Pap for normal mucosa were 0.857 and 0.769, respectively, which is considered reliable. CONCLUSION: N-Pit and n-Pap, seen using EC, are considered useful predictors of normal mucosa and the absence of H. pylori infection.