Chromoendoscopy and Magnification for the Evaluation of the Intragastric Extent of Atrophic Gastritis and Intestinal Metaplasia

Boeriu Alina¹, Dobru Daniela¹, Pascarenco Ofelia², Mocan Simona³, Onișor Danusia²

1 Internal Medicine VII, Gastroenterology Clinic, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Gastroenterology Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
3 Department of Pathology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

Introduction: The detection of intragastric extent and progression of atrophic gastritis and intestinal metaplasia are mandatory in order to quantify the risk of development of the gastric cancer. The aim of the study is to assess the clinical value of magnifying endoscopy and chromoendoscopy in the evaluation of the intragastric extent of atrophic gastritis and intestinal metaplasia.
Material and methods: We performed magnifying chromoendoscopy with methylene blue and we identified modified patterns corresponding to premalignant gastric lesions. We studied the intragastric extent of these lesions. Biopsy specimens were taken from modified areas in order to confirm the presence of atrophic gastritis and intestinal metaplasia.
Results: We identified specific pit patterns for atrophic gastritis and intestinal metaplasia. In 21 patients (30%) these lesions were confined to gastric antrum. In 7 cases (17.5%), lesions were extended in gastric corpus. These patients were selected for further endoscopic surveillance.
Conclusions: Magnifying endoscopy and chromoendoscopy allow the detection of intragastric extent of intestinal metaplasia and atrophic gastritis. This could help to a better selection of patients for surveillance endoscopy.