Stomach: Light Blue Crest Sign for Intestinal Metaplasia

Rami Esmat

Gastric Intestinal Metaplasiais a risk factor of intestinal-type gastric cancer, but WLI was not adequate to detect IM of stomach [1]. NBI system with and without magnification can excellently diagnose GIM with good histological agreement. Uedo et al. used a light blue crest (LBC) on epithelial surface by ME-NBI as a maker to diagnose IM with the sensitivity and specificity of 89% and 93%, respectively [2]. The LBC is a fine, blue-white line on the crests of the epithelial surface, and it can only be detected under wavelengths of 400–430 nm.

M. M. Walker, “Is intestinal metaplasia of the stomach reversible?” Gut, vol. 52, no. 1, pp. 1–4, 2003.
N. Uedo, R. Ishihara, H. Iishi et al., “A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy,” Endoscopy, vol. 38, no. 8, pp. 819–824, 2006.

Non-magnified NBI shows the non- metaplastic mucosa as brown and the intestinal metaplasia as areas with light blue crests (LBCs)