Korean J Helicobacter Up Gastrointest Res.  2013 Jun;13(2):78-83. 10.7704/kjhugr.2013.13.2.78.

Endoscopic Classification of Intestinal Metaplasia

• Bang BW
• Kim HG

• KMID: 2143421
• DOI: http://doi.org/10.7704/kjhugr.2013.13.2.78

Abstract

Intestinal metaplasia (IM) is recognized as a precancerous condition for intestinal type gastric cancer. Therefore, endoscopic diagnosis of IM is valuable for patients undergoing surveillance endoscopy. However, there are no standard endoscopic findings that distinguish it from the normal mucosa. Thus, biopsy is normally required to confirm the diagnosis of IM. Recently, the development of high-resolution image technique and some advanced endoscopic technologies such as chromoendoscopy, magnifying endoscopy with narrow band image and confocal laser endomicroscopy has significantly improved the ability to observe mucosal surface and identify IM. Although chromoendoscopy is time consuming, it is a useful method for diagnosis of IM. Narrow band imaging may enhance the accuracy of endoscopic surveillance of IM and dysplasia. Confocal laser endomicroscopy could provide in the real-time identification and classification of IM. Herein, we reviewed the clinical usefulness of white light endoscopy and several new endoscopic methods for the diagnosis of gastric intestinal metaplasia. Also, we will discuss appropriate follow-up period according to IM type and extension.

Keyword

Metaplasia; Endoscopy; Methylene blue; Narrow band imaging; Microscopy, Confocal

MeSH Terms

Biopsy
Endoscopy
Follow-Up Studies
Humans
Light
Metaplasia
Methylene Blue
Microscopy, Confocal
Mucous Membrane
Narrow Band Imaging
Precancerous Conditions
Stomach Neoplasms
Methylene Blue