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Introduction: Early diagnosis of gastric neoplasia involves both the detection and surveillance of patients with premalignant gastric lesions. Magnifying endoscopy allows the analysis of the fine mucosal structure and microvascular architecture. Material and methods: The aim of our study is to identify specific patterns associated with premalignant gastric lesions by magnifying endoscopy in conjunction with chromoscopy. We performed conventional upper endoscopies and we selected a number of patients for chromodiagnostic and magnification. We classified the endoscopic patterns in normal and abnormal (modified) patterns. Target biopsies were obtained from magnified areas and we analyzed the correspondence with the histological findings. Results: We identified specific pit patterns for normal gastric mucosa and for inflamed mucosa. A tubular pattern was associated with the detection of intestinal metaplasia. An irregular pattern and abnormal microvessels were endoscopic findings associated with the detection of high-grade dysplasia. An irregular form of collecting venules was detected in areas with atrophic gastritis. Conclusions: An initial selection of patients based on conventional endoscopic findings is mandatory. Gastric mucosal changes identified by magnifying endoscopy raise the number of detected premalignant lesions by targeted biopsies. Our work emphasizes the current challenges related to the use of these endoscopic methods. [ABSTRACT FROM AUTHOR]

Background and Aim: Gastric intestinal metaplasia represents a risk factor for intestinal type of gastric cancer. Gastric intestinal metaplasia seems to be associated with Helicobacter pilory infection in relatives of patients with gastric cancer. The aim of this study was to determine the prevalence, clinical, endoscopic and histological features of gastric intestinal metaplasia. Material and Methods: We retrospectively analyzed the esophagogastroduodenoscopies with biopsies performed between January 1, 2014 and October 31, 2014. Collected and analyzed data included age, gender, symptoms, endoscopic and histological findings. Results: Four hundred eighty-two patients were included in the study. One hundred thirty-seven patients had gastric intestinal metaplasia, which presented a prevalence was 28,4%. A similar distribution between gender was observed with a significant increase of gastric intestinal metaplasia with age (p=0,0001). Regarding the indication for endoscopy, the prevalence of gastric intestinal metaplasia was: 17 % among patients with dyspeptic syndrome, 2 % in patients with anemia and 5 % in patients examined for other symptoms. Endoscopic findings showed gastric intestinal metaplasia was significantly associated with atrophic gastritis (p=0.0001), erythematous gastritis (p=0.0079), while there was no association with erosive gastritis (p=0.24) and peptic ulcer (p=0.19). Conclusions: Gastric intestinal metaplasia is frequently recorded in patients undergoing in esophagogastroduodenoscopies with associated biopsies. Endoscopic findings like erythema and atrophy is strongly associated with gastric intestinal metaplasia emphasizing the importance of sampling biopsies. [ABSTRACT FROM AUTHOR]

Background: Often early gastric cancer (EGC) is asymptomatic, that is why most of the patients come for medical investigation already ill with advanced gastric cancer. The detection of premalignant gastric lesions and their control, help the exposure of gastric cancer in its initial stage and implicitly to a prompter access to the appropriate treatment for the patients. This study quantifies the utility of narrow band imaging-endoscopy (NBI) for the detection of premalignant lesions and early gastric cancer. Material and methods: This prospective study included 63 patients. They underwent an examination with white light endoscopy (WLE) and Sidney system of biopsy followed by magnifying NBI with targeted biopsies. We monitored the presence of EGC, dysplasia (Dis), intestinal metaplasia (IM). Results: IM was diagnosed in 60 patients, and 128 areas. Dis was detected in 11 patients and 13 areas and 2 patients had EGC. The premalignant gastric lesions were detected by both investigation methods. We followed sensibility, specificity, positive, negative predictive values. For NBI we obtained 81%, 75%, and for WLE 52%, 68%. The EGC was diagnosed only with NBI. Conclusions: NBI endoscopy is better than WLE for detected IM, Dis and EGC. This method can be used for screening EGC. [ABSTRACT FROM AUTHOR]