Interobserver agreement in the assessment of gastritis reversibility after Helicobacter pylori eradication

Abstract

Interobserver agreement in the application of the Sydney system to reversibility of gastritis after H. pylori was good. More strict criteria should be used for atrophy and to differentiate normal and mild chronic inflammation.

Interobserver variation in histopathological assessment ofHelicobacter pylorigastritis

“…This result was consistent with the study of Fiocca et al [20] (κ=0.62), Andrew et al [8] (κ=0.74) and Tepes et al [12] (κ=0.43), but lower than the value reported by El-Zimaity et al [9] (κ=0.90). Our results have also confirmed that H&E was an adequate stain for the detection of H pylori.…”

“…The κ values were 0.51-0.62 (CI: 0.40-0.85). As in our study, others have also shown a good agreement for scoring intestinal metaplasia, with κ values varying from 0.54 (CI: 0.31-0.77) in the study by Tepes et al [12] to 0.73 in the study by Andrew et al [8] . However, our κ values were lower than those reported by Fiocca et al [20 ; (κ=0.75-0.92).…”

“…Reliability in assessing intestinal metaplasia and atrophy in histological specimens was especially important because these changes were associated with an increased risk of gastric cancer [12,[17][18][19] . Andrew et al [8] and Tepes et al [12] held that histopathology was a reliable diagnostic method for H pylori gastritis based on their results. The best interobserver agreement was reached for intestinal metaplasia.…”

“…The lack of explicit criteria for the diagnosis of normal gastric mucosa when mononuclear cells were present, made grading difficult [12] . Therefore, the κ value for assessment of the degree of chronic inflammation (κ=0.49, CI:0.13-0.85) using semiquantitative scoring was lower than that for intestinal metaplasia and for the grading of H pylori in the present study.…”

“…The evaluation of interobserver agreement by using kappa (κ)-statistics has been accepted by pathologists for several years [9] . Although the histologic examination of gastric biopsy specimens is accepted as the gold standard [12,13] for the diagnosis of H pylori gastritis, it has not been demonstrated that histopathologic assessment is both accurate and reproducible [9] . The study was designed to test the reproducibility of the features of H pylori gastritis, using the updated Sydney classification by κ-statistics.…”