Endoscopic Classification of Intestinal Metaplasia

Bang, Byoung Wook; Kim, Hyung Gil

doi:2013.13.2.78

Korean J Helicobacter Up Gastrointest Res > Volume 13(2); 2013 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(2):78-83.
DOI: https://doi.org/10.7704/kjhugr.2013.13.2.78 Published online June 10, 2013.

Endoscopic Classification of Intestinal Metaplasia

Byoung Wook Bang, Hyung Gil Kim

Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. kimhg@inha.ac.kr

장상피화생의 내시경적 분류

방병욱, 김형길

인하대학교 의학전문대학원 내과학교실 소화기내과

Abstract

Intestinal metaplasia (IM) is recognized as a precancerous condition for intestinal type gastric cancer. Therefore, endoscopic diagnosis of IM is valuable for patients undergoing surveillance endoscopy. However, there are no standard endoscopic findings that distinguish it from the normal mucosa. Thus, biopsy is normally required to confirm the diagnosis of IM. Recently, the development of high-resolution image technique and some advanced endoscopic technologies such as chromoendoscopy, magnifying endoscopy with narrow band image and confocal laser endomicroscopy has significantly improved the ability to observe mucosal surface and identify IM. Although chromoendoscopy is time consuming, it is a useful method for diagnosis of IM. Narrow band imaging may enhance the accuracy of endoscopic surveillance of IM and dysplasia. Confocal laser endomicroscopy could provide in the real-time identification and classification of IM. Herein, we reviewed the clinical usefulness of white light endoscopy and several new endoscopic methods for the diagnosis of gastric intestinal metaplasia. Also, we will discuss appropriate follow-up period according to IM type and extension.

Key Words: Metaplasia; Endoscopy; Methylene blue; Narrow band imaging; Microscopy, Confocal