الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This prospective, blinded study included unselected 61 patients from the endoscopy unit of GIT section at Internal Medicine department Alexandria University.
An upper endoscopy was done for all patients for different indications such as Epigastric discomfort/pain which enrolled as Dyspepsia, Anemia, hematemesis, vomiting and Gastro-esophageal reflux disease.
Exclusion criteria includes
Gastrectomy or partial gastric resection, receiving antiplatelet medication, anticoagulant medications or NSAIDs, the presence of hemorrhagic diseases.
An informed consent was obtained from each patient. All subjects in the present study subjected to the following:
Full history taking focusing on family history of gastric cancer, infection with H.pylori, current medications, tobacco use, and coffee consumption, complete physical and clinical examination.
Routine laboratory exam that, including (CBC, Fasting or random blood sugar, Prothrombin time (PT) & international normalized ratio (INR), H. pylori test and CagA as virulent forms of H.pylori.(14)
Patients subjected to upper GI endoscopy examination using endoscope with narrow band imaging system (Olympus EVIS EXERA III CV-190) to detect the presence or absence of gastric IM.
Five biopsies as (two from the antrum, one from the angulus and two from the corpus) were collected from all patients.
Following white light examination, the gastric antrum & body was examined by NBI for blue-whitish patchy regions and then by NBI-ME observation at the maximum magnification, as LBC is frequently observed in these areas. If no blue-whitish areas are determined, NBI-ME was carried out at the proximal & distal parts of the following areas: the anterior wall, the posterior wall, the greater curvature, and the lesser curvature.
The patient was defined as LBC-negative if LBCs wasn’t detected in any of the image fields and as LBC-positive if LBCs was detected in any of the image fields.
Histopathological examination: Gastric endoscopic biopsies were fixed in 10% neutral buffered formation. Processed routinely, embedded in paraffin, and sectioned at 5 µm.
Evaluation of immunohistochemical staining
CDX2 Immunostaining was graded semi quantitatively, both percentage of positively-stained cells (nuclear staining) and staining intensity were taken into consideration.