Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia

Core Tip

Core tip: Image-enhanced endoscopy techniques such as narrow-band imaging (NBI) improve the diagnosis of Helicobacter pylori infection, atrophic gastritis, and gastric intestinal metaplasia (GIM). When NBI is combined with magnifying endoscopy, typical endoscopic findings can clearly be observed. Thus, the extent and severity of GIM can be endoscopically evaluated by close mucosal observation. Based on the microvascular patterns, fine network, core vascular, and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions. When the endoscopists find a small flat or depressed lesion, magnifying NBI endoscopy is helpful for differentiating between cancer and gastritis. The presence of a demarcation line and an irregular microvascular/microsurface pattern are highly suspicious for high grade dysplasia and cancer. For endoscopic treatment of early gastric cancer, the horizontal tumor margin can be assessed by magnifying NBI endoscopy.