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Diagnostic Yield of the Light Blue Crest Sign in Gastric Intestinal Metaplasia: A Meta-Analysis
Open accessAbstract
BACKGROUND: The diagnostic yield of light blue crest(LBC) sign, which was observed by narrow band imaging with magnification endoscopy(NBI-ME), in detecting gastric intestinal metaplasia(IM) has shown variable results. OBJECTIVE: We aimed to assess the diagnostic value of LBC under NBI-ME for detecting gastric IM. METHODS: We performed a literature search of the Medline/PubMed, Embase, Web of Science, Science Direct and the Cochrane Library Databases; and a meta-analysis of pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and SROC area under the curve, using fixed- and random-effects models, for the accuracy of LBC-based IM diagnosis. RESULTS: We initially included 4 articles, but excluded 1 article to counter significant heterogeneity. When pooled, the remaining 3 articles, which included 247 patients with 721 lesions, showed the following patterns in IM diagnosis: sensitivity: 0.90 (95% confidence interval [CI] 0.86-0.92); specificity: 0.90 (95% CI 0.86-0.93), positive likelihood ratio: 8.98 (95% CI 6.42-12.58), negative likelihood ratio: 0.12 (95% CI 0.09-0.16), and SROC area under the curve: 0.9560. LIMITATIONS: As the studies varied by their definitions for positive LBC, endoscopy types, biopsy protocols, race of patient cohort, and physicians' proficiency, some sample sizes were limited so that subgroup analyses could not be performed. CONCLUSION: We concluded that observing LBC under NBI-ME is an accurate and precise means of diagnosing gastric IM.
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The light blue crest sign is characteristic for intestinal metaplasia, with sensitivity and specificity approximately 90%, and positive and negative likelihood ratio 8.98 and 0.12, respectively, based on one meta-analysis.
“The “light blue crest” (LBC) sign, defined as fine, blue-white lines on the crests of the epithelial surface (Figure 2G), is characteristic for IM, with sensitivity and specificity approximately 90%, and positive and negative likelihood ratio 8.98 and 0.12, respectively, based on one meta-analysis.58,59”
From AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review (2021) · cites this paper as [58]
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Metadata
- Authors
- Wang, L., Huang, W., Du, J., Chen, Y., & Yang, J.
- Affiliations
- Zhejiang Provincial People's Hospital (CN)
- Corresponding author
- Huang, Wei
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-03-21
- Volume
- 9
- Issue
- 3
- Pages
- e92874
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3962461
- OpenAlex
- W2072888348
- Cited by
- 30
- References
- 27
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 1 · 2016: 1 · 2015: 1
- FWCI
- 0.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
- Health Sciences › Medicine › Gastroenterology › Helicobacter pylori-related gastroenterology studies
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- gastric intestinal metaplasia, narrow-band imaging, magnification endoscopy, diagnostic accuracy, sensitivity and specificity, likelihood ratios, SROC curve, endoscopic diagnosis
- MeSH terms
- Gastrointestinal Neoplasms, Humans, Metaplasia, Precancerous Conditions, ROC Curve, Reproducibility of Results, Endoscopy, Gastrointestinal, Area Under Curve
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