Can endoscopic atrophy predict histological atrophy? Historical study in United Kingdom and Japan
| Autor: | Ichiro Oda, Takuji Gotoda, Greg M Naylor, Fuminori Moriyasu, Michael Dixon, Luigi Gatta, Shigeaki Yoshida, Hitoshi Kondo, Anthony T. R. Axon, Shin Kono |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Gastritis Atrophic Male medicine.medical_specialty Biopsy Concordance Severity of Illness Index White People Young Adult Atrophy Asian People Japan Predictive Value of Tests Retrospective Study Gastroscopy Severity of illness Odds Ratio medicine Humans Grading (tumors) Aged Retrospective Studies Aged 80 and over Observer Variation Chi-Square Distribution medicine.diagnostic_test business.industry Age Factors Gastroenterology Reproducibility of Results Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease United Kingdom Surgery Logistic Models Gastric Mucosa Predictive value of tests Multivariate Analysis Female Radiology business |
| Zdroj: | World Journal of Gastroenterology. 21:13113 |
| ISSN: | 1007-9327 |
| DOI: | 10.3748/wjg.v21.i46.13113 |
| Popis: | AIM: To assess the diagnostic concordance between endoscopic and histological atrophy in the United Kingdom and Japan. METHODS: Using published data, a total of 252 patients, 126 in the United Kingdom and 126 in Japan, aged 20 to 80 years, were evaluated. The extent of endoscopic atrophy was classified into five subgroups according to a modified Kimura-Takemoto classification system and was compared with histological findings of atrophy at five biopsy sites according to the updated Sydney system. RESULTS: The strength of agreement of the extent of atrophy between histology and visual endoscopic inspection showed good reproducibility, with a weighted kappa value of 0.76 (P < 0.001). Multivariate analysis showed that three factors were associated with decreased concordance: Japanese ethnicity [odds ratio (OR) 0.22, 95% confidence interval (CI) 0.11-0.43], older age (OR = 0.32, 95%CI: 0.16-0.66) and endoscopic atrophy (OR = 0.10, 95%CI: 0.03-0.36). The strength of agreement between endoscopic and histological atrophy, assessed by cancer risk-oriented grading, was reproducible, with a kappa value of 0.81 (95%CI: 0.75-0.87). Only nine patients (3.6%) were endoscopically underdiagnosed with antral predominant rather than extensive atrophy and were considered false negatives. CONCLUSION: Endoscopic grading can predict histological atrophy with few false negatives, indicating that precancerous conditions can be identified during screening endoscopy, particularly in patients in western countries. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|