Role of NBI and WLE in diagnosis of Barrett’s esophagus in patients with chronic gastroesophageal reflux disease

Abstract:Background: Recent data have emerged that a targeted biopsy technique using Narrow-Band Imaging (NBI) could be considered in patients undergoing surveillance for Barrett’s esophagus (BE).Aim of the study: to determine the role of NBI versus conventional- white light endoscopy (WLE) in diagnosis of Barrett’s esophagusSubjects and methods: the study included 274 patients with chronic reflux symptoms, conventional- white light endoscopy (WLE) was done in all cases for diagnosis of BE, 4-random biopsies were taken and examined by histopathology for detection of columnar-lined intestinal metaplasia, patients tested negative were re-examined by NBI and targeted biopsy were taken in patients for confirmation of presence of intestinal metaplasia.Results: 90 patients had columnar-lined epithelium (CLE) by WLE (32.8%); Seventy- three patients with 4 quadrant biopsy technique confirmed to have intestinal metaplasia (81.1% of cases with endoscopic BE, and 26.6% of all screened patients), 17 patients with negative histopathology for BE were re-examined endoscopically and NBI - targeted biopsies were taken, 7 patients of them showed intestinal metaplasia, so total patients confirmed to have BE has risen to 80 patients (88.9%).Conclusion: NBI- targeted biopsies could diagnose BE in patients tested negative by WLE taken biopsies