ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1642702
Diagnostic Efficacy of Magnifying Endoscopy with Blue Laser Imaging for Laryngopharyngeal Reflux
Provisionally accepted
Rong Wang1,2
Min Yu3Chaoyuan Chen1Xi Chen4Yongxiu Lin2Jianzhen Li2Gang Liu2Huan Huang2Dazhou Li2*
Wen Wang2*- 1Department of Gastroenterology, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- 2Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- 3Department of General Medicine, Qiaoying Subdistrict Health Service Center of Jimei District, Xiamen, China
- 4Department of Otolaryngology, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Objectives: We aimed to analyze the utility of magnifying endoscopy with blue laser imaging (ME-BLI) in diagnosing laryngopharyngeal reflux (LPR). Methods: The study enrolled 106 patients based on LPR-related symptoms. Using the reflux symptom index (RSI) and reflux finding score (RFS) scales as the clinical reference standard, the study cohort comprised 68 patients with LPR (RSI > 13 and/or RFS > 7) and 38 controls (RSI ≤ 13 and RFS ≤ 7). All participants underwent upper gastrointestinal endoscopy with ME-BLI. The patients were classified into grades 1–4 based on the pharyngolaryngeal appearance under ME-BLI and the visibility and characteristics of intraepithelial papillary capillary loops (IPCLs) in the pharyngolaryngeal mucosa. Grades 3 and 4 were defined as LPR-positive. The diagnostic performance of ME-BLI for LPR was compared to the RSI/RFS criteria. Results: Compared with the RSI/RFS clinical reference standard, ME-BLI demonstrated a sensitivity of 89.71% (95% CI: 81.54–94.44%), a specificity of 73.68% (95% CI: 59.72–84.03%), a positive predictive value of 85.92% (95% CI: 76.34–92.04%), and a negative predictive value of 80.00% (95% CI: 64.06–90.04%) for LPR diagnosis. It also showed good consistency with RSI/RFS diagnosis (Kappa = 0.65, 95% CI: 0.52–0.78, P < 0.001). Good interobserver agreement in ME-BLI grading was noted (ICC = 0.858, P < 0.001). Conclusion: LPR has characteristic pharyngeal manifestations. ME-BLI could potentially improve LPR diagnostic accuracy; however, further validation is required.
Keywords: blue laser imaging, Magnifying endoscopy, Laryngopharyngeal Reflux, GERD (gastroesophageal reflux disease), Dignosis
Received: 07 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Wang, Yu, Chen, Chen, Lin, Li, Liu, Huang, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dazhou Li, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
Wen Wang, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
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