Correlation between Endoscopic and Histological Diagnoses of Gastric Intestinal Metaplasia

Abstract

Background/AimsIntestinal metaplasia (IM) is a premalignant condition. This study aimed to evaluate the correlation between endoscopic and histological findings of IM.MethodsThe cases of IM were graded by conventional endoscopy, and biopsies were taken from the antrum and body of 1,333 subjects for histological IM diagnosis. Multivariate analyses were performed to identify the factors that affect the sensitivity of endoscopic IM diagnosis.ResultsThe sensitivity/specificity of endoscopic IM diagnosis based on histology was 24.0%/91.9% for the antrum and 24.2%/88.0% for the body. As indicated by multivariate analysis, the presence of endoscopic atrophic gastritis (AG) (odds ratio [OR], 4.73; 95% confidence interval [CI], 2.07 to 10.79) and the activity of mucosal inflammation (OR, 2.21; 95% CI, 1.08 to 4.54) were associated with the sensitivity of endoscopic IM diagnosis in the antrum, while the presence of endoscopic AG (OR, 8.02; 95% CI, 4.55 to 14.15), dysplasia (OR, 2.40; 95% CI, 1.07 to 5.39), and benign gastric ulcers (OR, 0.35; 95% CI, 0.15 to 0.081) were associated with the sensitivity of endoscopic IM diagnosis in the body.ConclusionsAs the sensitivity of endoscopic IM diagnosis was low, a high index of suspicion for IM is necessary in the presence of atrophy, and confirmation by histology is also necessary.

Diagnosis and Treatment of Helicobacter Pylori Infection: Main Statements of the Maastricht v/Florence Consensus Report (2015)

“…Детальная гистологическая оценка гистоморфоло-гических изменений слизистой оболочки желудка (СОЖ) требует проведения биопсии как из участка антрального отдела, так и из тела желудка [24]. Дан-ная тактика позволяет более точно оценить риск раз-вития рака желудка.…”

Atrophic Gastritis and Intestinal Metaplasia

“…Especially, endoscopic diagnosis of AG was inaccurate below 50 years of age because mild atrophic mucosal change may look normal in endoscopy [ 76 ]. In addition, the sensitivity and specifi city of endoscopic IM diagnosis were also low in study by Lim et al [ 86 ]. The sensitivity and specifi city of endoscopic diagnosis of IM based on histology were 24.0 % and 91.9 % for the antrum and were 24.2 % and 88.0 % for the corpus.…”

“…The sensitivity and specifi city of endoscopic diagnosis of IM based on histology were 24.0 % and 91.9 % for the antrum and were 24.2 % and 88.0 % for the corpus. As indicated by a multivariate analysis, the activity of mucosal infl ammation and the presence of endoscopic AG were associated with the sensitivity of endoscopic diagnosis of IM in the antrum, while benign gastric ulcers, dysplasia, and the presence of endoscopic AG were associated with the sensitivity of endoscopic diagnosis of IM in the corpus [ 86 ]. Thus, a high level of suspicion is important to increase the sensitivity of endoscopic diagnoses of IM, especially when adenoma, endoscopic AG, and ulcer are present, and confi rmation of the doubt by histological diagnosis is necessary.…”

Diagnóstico precoz de cáncer gástrico: Propuesta de detección y seguimiento de lesiones premalignas gástricas: protocolo ACHED

“…Los familiares de primer grado de pacientes con CG tienen 2 a 10 veces más riesgo de CG 25,26 y una mayor frecuencia y precocidad de AG 27,28 . La endoscopia tiene mal rendimiento diagnós-tico en occidente 29,30 , por lo que el diagnóstico de AG/ MI requiere biopsias sistemáticas del cuerpo y antro 24,31,32 . El protocolo de Sydney modificado 33 incluye 5 biopsias (2 en antro y cuerpo y una en el ángulo) y es el más aceptado.…”