Biopsy strategies for endoscopic screening of pre-malignant gastric lesions
| Autor: | Jing Zhao, Haibiao Bao, Yi Xu, Yue Hu, Shan Liu, Meng Zhang, Xiaoteng Wang, Bin Lu, Lina Meng |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Biopsy lcsh:Medicine Gastroenterology 0302 clinical medicine Clinical Protocols Risk Factors Mass Screening Prospective Studies Prospective cohort study lcsh:Science Antrum Early Detection of Cancer Aged 80 and over Multidisciplinary medicine.diagnostic_test Intestinal metaplasia Middle Aged Curvatures of the stomach 030220 oncology & carcinogenesis Gastritis Practice Guidelines as Topic 030211 gastroenterology & hepatology Female medicine.symptom Adult Gastritis Atrophic medicine.medical_specialty Pre malignant Article 03 medical and health sciences Young Adult Stomach Neoplasms Internal medicine Gastroscopy medicine Humans Aged Metaplasia business.industry lcsh:R Cancer medicine.disease ROC Curve Gastric Mucosa lcsh:Q business Gastric cancer Precancerous Conditions |
| Zdroj: | Scientific Reports Scientific Reports, Vol 9, Iss 1, Pp 1-10 (2019) |
| ISSN: | 2045-2322 |
| Popis: | Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) were adopted to evaluate gastric risk stratification in five biopsy samples. This study aimed to evaluate the degree of gastric atrophy (GA) and intestinal metaplasia (IM) in five locations to detect a more representative biopsy sample in gastric cancer (GC) screening. Our study enrolled 368 patients and 5 biopsy pieces were acquired from them. Gastric risk stratification was calculated by OLGA and OLGIM staging system. The results revealed that the IM score in the incisura angularis was higher than that in the larger and lesser curvature of corpus mucosa (p = 0.037 and p = 0.030, respectively) and the IM score in the lesser curvature of antrum mucosa was higher than that in the incisura angularis mucosa (p = 0.018). IM is more frequently observed in the angulus region than in the lesser curvature of corpus in the mild degree (p = 0.004) and mild IM lesions in the lesser curvature of antrum were more frequently observed than in the incisura angularis mucosa (p = 0.004), Four biopsy pieces protocol (larger curvature and lesser curvature of the antrum, lesser curvature of the corpus and angulus) demonstrated accurate consistency (97.83% and 98.37%, respectively) with a Kendall’s tau-b of higher than 0.990, along with low misdiagnosis rates of OLGA and OLGIM (III + IV) (9.76% and 5.00%, respectively). Three biopsy pieces protocol (lesser curvature of the antrum and corpus, angulus biopsy) in OLGA and OLGIM staging system was close to the standard protocol (five biopsy specimens) with a consistency of 94.84% and 94.29% and has a Kendall’s tau-b higher than 0.950 and diagnostic omission rates of 9.76% and 5.00%, respectively, which was exactly the same with the four biopsy pieces protocol. Furthermore, it had the second-highest Youden index (0.902 and 0.950, respectively) and area under the ROC curve (0.992 and 0.996, respectively) for the screening of high-risk GC by OLGA and OLGIM stages. Thus, we recommended the angulus and the lesser curvature of antrum as a conventional biopsy and three biopsy pieces for further GC risk screening. |
| Databáze: | OpenAIRE |
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