Correlation among standard endoscopy, narrow band imaging, and histopathological findings in the diagnosis of nonerosive reflux disease

Abstract

Background and aims: Gastroesophageal reflux disease (GERD) is caused by the reflux of gastric contents into the esophagus. Narrow band imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of GERD. The diagnosis of GERD is based on the combination of clinical symptoms, endoscopic findings, and histological changes. In this study we aimed to show the differences between standard white light endoscopy and the NBI technique in squamo-columnar junction evaluation. We also evaluated the patients with NERD, as determined by standard white light endoscopy, using the NBI technique and histopathological mucosa examination (inflammation or normal mucosa).

Methods: A total of 60 subjects were recruited prospectively: 40 with nonerosive reflux disease (NERD) and 20 with erosive reflux disease (ERD). Patients were subjected to esophagogastroduodenoscopy and, in all of them, two biopsies were taken 2 cm above the esophagogastric junction.

Results: NBI was more sensitive than standard white light endoscopy in distinguishing normal endoscopic findings. Histopathological findings were more prevalent than the mucosal changes diagnosed by the standard white light endoscopy and NBI.

Conclusion: NBI is more sensitive than white light endoscopy in detecting inflammation in NERD patients. However, histopathological evaluation is the most sensitive, therefore taking a biopsy will remain useful.