Role of Narrow band Imaging (NBI) in Detection of H. Pylori induced gastric intestinal metaplasia in Egyptian patients

Massoud, Ahmed Mohamed; Ghazy, Ahmed Mohamed; Mohammed, Ahmed Eldemerdash Ahmed; Alshahat, Mohamed Alsayed Mahmoud

doi:10.21608/aimj.2025.446523

Role of Narrow band Imaging (NBI) in Detection of H. Pylori induced gastric intestinal metaplasia in Egyptian patients

Document Type : Original Article

Authors

Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446523

Abstract

Background: Helicobacter pylori (H. pylori) colonizes the stomach mucosa of over 50% of the global population. Persistent infection progresses from gastritis to atrophy, intestinal metaplasia, dysplasia, and gastric adenocarcinoma. In Egypt, H. pylori-induced gastritis is prevalent. Narrow-band imaging (NBI) enhances early detection of premalignant lesions.
Aim: To assess the validity and accuracy of narrow-band imaging in the identification of H. pylori-related gastric intestinal metaplasia.
Patients and methods: This cross-sectional investigation was done on 250 symptomatic cases with positive Helicobacter pylori infection at the El-Sayed Galal Hospital endoscopy unit from December 2023 to July 2024. Based on endoscopic findings and histopathological results, 130 patients were diagnosed with non-atrophic gastritis (excluded from the investigation), while 120 cases were diagnosed with atrophic gastritis (involved in the investigation). The atrophic gastritis patients were further classified into two groups: Group 1, atrophic gastritis without intestinal metaplasia (95 patients), and Group 2, atrophic gastritis with intestinal metaplasia (25 patients).
Results: NBI demonstrated a sensitivity of 88%, specificity of 89.5%, and overall diagnostic accuracy of 89.2% in detecting gastric intestinal metaplasia compared to histopathology. The light blue crest (LBC) was the most common NBI pattern found in IM cases, while all cases of white opaque substance (WOS) were related to an elevated risk of gastric cancer, depending on the OLGIM score.
Conclusion: NBI accurately diagnoses intestinal metaplasia, with the light blue crest being the most common. High OLGIM stages are independent risk factors for gastric cancer.

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