Positive predictive value sequential testing

Methylene blue chromoendoscopy is the only technique that provides a good validity score for GIM targeted biopsy. Multiple random biopsies under white light endoscopy to detect GIM are quite cumbersome as they are time-consuming and have the possibility of missing a small lesion. However, conventional white light endoscopy has a limitation in selection of the area for surveillance biopsy. The benefit of annual endoscopic surveillance in these high risk patients has been shown to improve survival by enhancing the detection of gastric cancer at the early stage. Although diffuse type gastric cancer can arise independently of GIM, in many cases GIM may be found nearby. In CorreaвЂ™s gastric cancer cascade, gastric intestinal metaplasia (GIM) is an important precancerous lesion for the development of intestinal type gastric cancer. However, the optimal duration between two surveillances requires further study. LBC provided the highest LR+ over VP and LLC.Д¬ONCLUSION: Non-sequential NBI is useful for GIM targeted biopsy. Surgical and endoscopic resections were successfully performed in each patient. No cancer was detected from the second study. There were 2 early gastric cancers detected in the first endoscopy. RESULTS: NBI targeted biopsy was performed in 38 and 26 patients during the first and second surveillance endoscopies, respectively. The number of early gastric cancer cases detected was also reported. The results from two surveillance endoscopies were compared with histology results for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio of positive test (LR+).

The authors compared the endoscopic criteria such as light blue crest (LBC), villous pattern (VP), and large long crest (LLC) with standard histology. METHODS: Previously diagnosed GIM patients underwent targeted biopsy from areas with and without GIM, as indicated by NBI, twice at an interval of 1 year. AIM: To evaluate the efficacy of non-sequential narrow band imaging (NBI) for a better recognition of gastric intestinal metaplasia (GIM).

Positive predictive value sequential testing