Utility of autofluorescence imaging videoendoscopy system for the detection of minimal changes associated with reflux esophagitis.

been facilitated by the introduction of en− doscopic imaging at high resolution. Re− cently, minimal changes at the squamo− columnar (SC) junction have attracted clinical interest; these are defined by en− doscopists as white−colored changes to the esophageal mucosa near the SC junc− tion. This finding is commonly accepted for inclusion in a modified LA classifica− tion “grade M (minimal change)”, as part of the spectrum of reflux esophagitis in Japan [1]. The clinical implications of such minimal changes are considered sig− nificant [2, 3]. Because reliable detection of the white−color change of the esopha− geal mucosa is difficult, the consistency of diagnosis varies among endoscopists. Recently, the autofluorescence imaging (AFI) videoendoscopy system (Olympus Corp., Tokyo, Japan) was developed for di− agnosis of hyperplasia and inflammation of the gastrointestinal tract. Here, we in− vestigate endoscopically detectable dif− ferences between normal controls and the white−colored esophageal mucosa of reflux esophagitis grade M using white light imaging (WLI) endoscopy and AFI. Fourteen cases (normal esophagus, n = 8; minimal change, n = 6) were investigated with WLI and AFI simultaneously. Esoph− ageal mucosa recognized as normal by WLI appears green by AFI, whereas WLI− detected white−colored esophageal mu− cosa appears pink by AFI (l" Fig. 1). Histo− logic examination has shown that the epithelium is thickened in white−colored mucosa [4], which may lead to decreased autofluorescence in the lesion. By using AFI, we can easily distinguish the white− colored from the normal mucosa. It is therefore suggested that AFI is useful for the detection of minimal changes, ap− pearing as pink−colored esophageal mu− cosa in reflux esophagitis grade M.