Z Gastroenterol 2009; 47 - A2
DOI: 10.1055/s-0029-1223981

Evaluation of patients with endoscopically suspected esophageal metaplasia (ESEM) by trimodal – High resolution magnifying endoscopy (HRME), endoscopic autofluorescence (AFI) and narrow band imaging (NBI) endoscopic technique – Initial Hungarian experience

É Benkő 1, C Ocskó 1, I Németh 2, F Izbéki 1, R Róka 1, K Gecse 1, K Vadászi 1, L Tiszlavicz 2, T Wittmann 1, A Rosztóczy 1
  • 1First Department of Medicine, University of Szeged
  • 2Department of Pathology, University of Szeged

Background: Trimodal imaging endoscopy – HRME, AFI, and NBI – is a new promising technique for the detection of early neoplasias in patients with ESEM. In contrast to the conventional endoscopy this new technique may allow us to obtain targeted biopsies from suspicious lesions.

Materials and methods: Seventeen patients (M/F 12/5 mean age: 59.2 years) with ESEM were submitted to HRME, AFI and NBI (Olympus GIF-FQ 260Z). Biopsy sampling was made on the conventional way (4 samples in every 2cm-s) on the one hand, and from all suspicious lesions detected by the trimodal imaging. The type of metaplasia and the presence of dysplasia were established by conventional histological staining techniques and immunohistochemistry.

Results: The mean length of ESEM was 4.4±0.9 cms. HRME and NBI evaluation of the patients with ESEM 10/17 subjects had pit patterns representative for gastric metaplasia. Histology confirmed the endoscopic diagnosis in all cases. Specialized intestinal metaplasia was suspected in 13/17 patients, of which 11/13 were proved by histology. Neither HRME, NBI nor AFI identified any suspicious lesions for high grade dysplasia or early carcinoma in the studied patients. Histological evaluation of the biopsies did not show more severe stage of the disease than low grade dysplasia. One patient had a large esophageal ulcer, which was diagnosed to be benign by both trimodal endoscopy and histology.

Conclusions: In our preliminary study trimodal endoscopic imaging did not provide any false negative result and it seems to be a useful tool for the evaluation of patients with ESEM.

The study was organized by the South Hungarian Regional Surveillance Group for the Study of Barrett's Esophagus (B Bod, L Czakó, J Csanádi, K Csefkó, Zs F. Kiss, P. Fritz, C Góg, J Hudák, K Intzédy, K Jármay, Zs Kálló, M Karácsony, Gy Lázár, Zs Lénárt, K Lovik, T Molnár, F Nagy, L Oczella, A Paszt, S Radics, L Szalay, K Szentpáli, A Szepes, Z Szepes, Gy Szlovák, A Tiszai, A Titz, M Varga, A Váry, J Zombori).

Grant supports: Olympus Hungary Kft., Nycomed Hungary Kft., ETT T02–515/2006.