Background and study aims: Gastric intestinal metaplasia (GIM) is a risk factor for development of intestinal−type gastric cancer. We aimed to as− sess the usefulness of confocal laser endomicros− copy (CLE) in diagnosing GIM. Patients and methods: 28 patients with known GIM underwent CLE, and CLE criteria for diagno− sis of GIM were developed. In addition, 53 conse− cutive patients with known or suspected GIM were prospectively evaluated. Results: GIM was identified if any of the follow− ing three features were present in an image field: goblet cells, columnar absorptive cells and brush border, and villiform foveolar epithelium. GIM was then classified as complete or incomplete ac− cording to the shape of the goblet cells, the pres− ence of absorptive cells or brush border, and the architecture of vessels and crypts. In a prospec− tive study, a total of 13 670 CLE images were ob− tained. Among 267 sites from 53 patients, 160 from 36 patients were diagnosed histopathologi− callyas GIM. The sensitivities of conventional en− doscopy and CLE for GIM were 36.88% vs. 98.13%, and the specificities were 91.59% vs. 95.33%, respectively. The kappa value for the correlation with histological findings was 0.25 for conven− tional endoscopy vs. 0.94 for CLE. The sensitivity and specificity of CLE were 68.03% and 89.66%, respectively, for the diagnosis of complete GIM, and 68.42% and 83.41%, respectively, for incom− plete GIM; the kappa value for the correspon− dence between CLE and histological findings was 0.67. Conclusion: CLE is a useful and potentially im− portant method for the diagnosis and classifica− tion of GIM in vivo.

第一署名医院：山东大学齐鲁医院；山东中医药大学附属第二医院