ارزش اندوسكوپي زوم در تشخيص اتروفي مخاط معده در بيماران مراجعه كننده به بخش اندوسكپي بيمارستان شريعتي تهران

The value of zoom endoscopy in the diagnosis of gastric mucosal atrophy in the patients referring to the Endoscopy Ward,Shariati Hospital, Tehran

Endoscopy is animportant procedure for diagnosis of lesions in upper gastrointestinal tract. Zoom or magnifying endoscopy is a new development in fiberoptic technology providing the possibility for observation of mucosal lesions with much higher magnifications than usual. Gastric mucosal atrophy, a consequence of chronic gastritis,is considered as a high risk condition and a possible precancerous lesion for gastric adenocarcinoma by many authorities. The objective of the study was determination of the efficacy of zoom versus routine endoscopy for diagnosis of gastric mucosal atrophy. Digital pictures taken from gastric mucosa by both routine and zoom video endoscope were independently examined by an experienced gastroenterologist for presence and severity of mucosal atrophy. Biopsy specimens taken from the same sites were blindly observed by a pathologist and reported accordingly. Pathologic examination of 178 satisfactory specimens showed 30% atrophic changes in the antrum and 18.8% in the body. Sensitivity and specificity of zoom endoscopy for diagnosis of gastric mucosal atrophy were 45 and 87%, respectively. The figures were 12 and 93% for routine endoscopy. Likelihood ratio showed to be 3.4 for zoom and 1.7 for routine endoscopy. According to the results, zoom endoscopy showed to be more efficient for diagnosis of gastric mucosal atrophy in this study. Further studies are suggested to ensure reproducibility of the results and proposing better visual criteria for better diagnosis of different mucosal lesions by zoom endoscope. This will certainly help for finding the representative site for biopsy and pathologic confirmation of the endoscopic diagnoses.