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CC BY 4.0 · Endosc Int Open 2025; 13: a26857610
DOI: 10.1055/a-2685-7610
Original article

Narrow band imaging complements eosinophilic esophagitis reference score in predicting inflammatory infiltration in patients with dysphagia

Authors

  • Kotryna Truskaite 

    1   Department of Medicine at Huddinge, Karolinska Institute, Stockholm, Sweden (Ringgold ID: RIN27106)
    2   Division of Gastroenterology, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden (Ringgold ID: RIN59562)

  • Laura Vossen Engblom

    1   Department of Medicine at Huddinge, Karolinska Institute, Stockholm, Sweden (Ringgold ID: RIN27106)
    3   Center for Bioinformatics and Biostatistics, Karolinska Institute, Stockholm, Sweden (Ringgold ID: RIN27106)

  • Greger Lindberg

    1   Department of Medicine at Huddinge, Karolinska Institute, Stockholm, Sweden (Ringgold ID: RIN27106)
    2   Division of Gastroenterology, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden (Ringgold ID: RIN59562)

  • Aldona Dlugosz

    1   Department of Medicine at Huddinge, Karolinska Institute, Stockholm, Sweden (Ringgold ID: RIN27106)
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Abstract

Background and study aims

Magnifying endoscopy with narrow-band imaging (ME-NBI) is regularly used in neoplasia diagnostics although its use in assessment of esophageal inflammatory changes is uncommon. The aim of this study was to evaluate the efficacy of eosinophilic esophagitis reference score and ME-NBI signs in predicting inflammation using gastroscopy with dual focus in patients with dysphagia.

Patients and methods

We conducted a prospective cohort study in adults undergoing gastroscopy with esophageal biopsies because of dysphagia/food bolus impaction. Number of eosinophiles and lymphocytes were calculated per high-power field. We used logistic regression with forward stepwise selection to determine the most relevant predictors (endoscopic signs) of inflammation. To assess the predictive value of endoscopic signs for eosinophilic or lymphocytic infiltration, we calculated sensitivity, specificity, and predictive values.

Results

In total 219 patients (71.2% male) were enrolled to the study. Most frequent endoscopic findings were furrows (121/219, 55%), positive NBI signs (106/219, 48%), and edema (102/219, 47%). Logistic regression analysis showed that furrows and NBI signs were the most significant predictors of eosinophilic infiltration. Edema was the only significant predictor of lymphocyte infiltration.

Conclusions

Positive NBI signs and furrows were the best predictors of eosinophile infiltration, whereas lymphocytic infiltration was predicted by edema. Given that NBI is already widely available, we encourage use of both white light and NBI in patients with suspected esophageal inflammation.

Keywords

Endoscopy Upper GI Tract - Eosinophilic esophagitis - Benign strictures - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)

Supplementary Material



Publication History

Received: 06 February 2025

Accepted after revision: 08 August 2025

Accepted Manuscript online:
18 August 2025

Article published online:
09 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Kotryna Truskaite, Laura Vossen Engblom, Greger Lindberg, Aldona Dlugosz. Narrow band imaging complements eosinophilic esophagitis reference score in predicting inflammatory infiltration in patients with dysphagia. Endosc Int Open 2025; 13: a26857610.
DOI: 10.1055/a-2685-7610
 

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