Linked Color Imaging for the Assessment of Minimal Change Lesions in Patients With Nonerosive Reflux Esophagitis

For a study, researchers sought to assess the effectiveness of LCI and WLI endoscopy in evaluating MCL in NER patients. Conventional white-light imaging (WLI) endoscopy, on the other hand, had a hard time detecting MCL. Linked color imaging (LCI), a breakthrough image-enhanced endoscopic method with significant, distinctive color enhancement, was used to detect Helicobacter pylori infection and early stomach cancer. Between August 2017 and July 2018, 41 patients with NERD and 38 volunteers with no gastroesophageal reflux disease (non-GERD) were recruited for this study. Using WLI and LCI, the distal 5 cm of the esophagus mucosal morphology at the squamocolumnar junction was seen during upper gastrointestinal endoscopy. Erythema, blurring of the Z-line, friability, diminished vascularity, white turbid staining, and edema or accentuation of the mucosal folds were all considered MCL. In all groups, three experienced endoscopists evaluated the color patterns for MCL on WLI and WLI paired with LCI images. About 2 centimeters above the esophagogastric junction, a biopsy was collected. A pathologist scored histologic slides in a blinded manner. Using WLI paired with LCI, the proportion of MCL was larger in patients with NERD (70.7%, 29/41) than in individuals with non-GERD (39.5%, 15/38). Both WLI and LCI revealed normal mucosa in 12 NERD patients. In patients with NERD, the MCL detection rate was considerably greater when WLI was paired with LCI (70.7 % vs. 51.2%, P=0.039) than when WLI was used alone (51.2% vs. 70.7%, P=0.039). In both the NERD group (4.59±0.32 vs. 2.36±0.34, P<0.01) and the non-GERD group (3.47±0.50 vs. 2.00±0.28, P<0.01), the histopathologic score of MCL (+) patients was considerably higher than that of MCL (-) patients. Compared to WLI alone, LCI had higher intraobserver repeatability and interobserver agreement. MCL was shown to be more frequent in NERD patients than in non-GERD individuals. In patients with NERD, WLI paired with LCI can be used to identify MCL. Compared to WLI, LCI was more sensitive in diagnosing MCL since it enhanced endoscopic pictures.

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