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Published in: Digestive Diseases and Sciences 5/2010

01-05-2010 | Original Article

The Correlation of Endoscopic and Histological Diagnosis of Gastric Atrophy

Authors: Alisher Eshmuratov, Jong Chun Nah, Nayoung Kim, Hye Seung Lee, Hee Eun Lee, Byoung Hwan Lee, Min Sik Uhm, Young Soo Park, Dong Ho Lee, Hyun Chae Jung, In Sung Song

Published in: Digestive Diseases and Sciences | Issue 5/2010

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Abstract

Purpose

Gastric atrophy is a premalignant condition. The aim of this study was to evaluate the correlation between histological and endoscopic findings of atrophy, and to analyze the affecting factors.

Methods

Atrophy was graded by endoscopy, and biopsy was performed in the antrum and body for the diagnosis of atrophy according to the Sydney system in the 1,330 subjects.

Results

Both endoscopic and histological atrophy increased in proportion to age (P < 0.001). The prevalence of endoscopic atrophy was significantly lower than that of histological atrophy especially below 50 years of age. The sensitivity and specificity of endoscopy for the diagnosis of atrophy based on histological diagnosis of atrophy were 61.5 and 57.7% in the antrum, and were 46.8 and 76.4% in the body of the stomach. Multivariate analysis showed that an age <50 (OR 0.38, 95% CI 0.25–0.61) and a PG I/II ratio >3 (OR 0.50, 95% CI 0.35–0.71) in the antrum, and an age < 50 (OR 0.43, 95% CI 0.19–1.00) and a CRP > 5 mg/dl (OR 0.53, 95% CI 0.30–0.94) decreased the sensitivity of the endoscopic diagnosis of atrophy in the body.

Conclusions

A high index of suspicion of gastric atrophy is important in the young age group, and confirmation of the diagnosis by histology is necessary.
Literature
1.
go back to reference Correa P. Human gastric carcinogenesis: a multistep and multifactorial process—First American Cancer Society Award lecture on cancer epidemiology and prevention. Cancer Res. 1992;52:6735–6740.PubMed Correa P. Human gastric carcinogenesis: a multistep and multifactorial process—First American Cancer Society Award lecture on cancer epidemiology and prevention. Cancer Res. 1992;52:6735–6740.PubMed
2.
go back to reference Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988;48:3554–3560.PubMed Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988;48:3554–3560.PubMed
8.
go back to reference Kaur G, Raj SM. A study of the concordance between endoscopic gastritis and histological gastritis in an area with a low background prevalence of Helicobacter pylori infection. Singapore Med J. 2002;43:090–092.PubMed Kaur G, Raj SM. A study of the concordance between endoscopic gastritis and histological gastritis in an area with a low background prevalence of Helicobacter pylori infection. Singapore Med J. 2002;43:090–092.PubMed
10.
go back to reference Redéen S, Petersson F, Jönsson KA, Borch K. Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample, Sweden. Endoscopy. 2003;35:946–950. doi:10.1055/s-2003-43479.CrossRefPubMed Redéen S, Petersson F, Jönsson KA, Borch K. Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample, Sweden. Endoscopy. 2003;35:946–950. doi:10.​1055/​s-2003-43479.CrossRefPubMed
11.
go back to reference Atkins L, Benedict EB. Correlation of gross gastroscopic findings with gastroscopic biopsy in gastritis. N Engl J Med. 1956;254:641–644.PubMedCrossRef Atkins L, Benedict EB. Correlation of gross gastroscopic findings with gastroscopic biopsy in gastritis. N Engl J Med. 1956;254:641–644.PubMedCrossRef
13.
go back to reference Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of a gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol. 1989;24:385–395. doi:10.3109/00365528909093064.CrossRefPubMed Jönsson KA, Gotthard R, Bodemar G, Brodin U. The clinical relevance of endoscopic and histologic inflammation of a gastroduodenal mucosa in dyspepsia of unknown origin. Scand J Gastroenterol. 1989;24:385–395. doi:10.​3109/​0036552890909306​4.CrossRefPubMed
14.
go back to reference Myren J, Serck-Hanssen A. The gastroscopic diagnosis of gastritis, with particular reference to mucosal reddening and mucus covering. Scand J Gastroenterol. 1974;9:457–462.PubMed Myren J, Serck-Hanssen A. The gastroscopic diagnosis of gastritis, with particular reference to mucosal reddening and mucus covering. Scand J Gastroenterol. 1974;9:457–462.PubMed
15.
go back to reference Fung WP, Papadimitriou JM, Matz LR. Endoscopic, histological and ultrastructural correlations in chronic gastritis. Am J Gastroenterol. 1979;71:269–279.PubMed Fung WP, Papadimitriou JM, Matz LR. Endoscopic, histological and ultrastructural correlations in chronic gastritis. Am J Gastroenterol. 1979;71:269–279.PubMed
17.
go back to reference Toukan AU, Kamal MF, Amr SS, Arnaout MA, Abu-Romiyeh AS. Gastroduodenal inflammation in patients with nonulcer dyspepsia. A controlled endoscopic and morphometric study. Dig Dis Sci. 1985;30:313–320. doi:10.1007/BF01403839.CrossRefPubMed Toukan AU, Kamal MF, Amr SS, Arnaout MA, Abu-Romiyeh AS. Gastroduodenal inflammation in patients with nonulcer dyspepsia. A controlled endoscopic and morphometric study. Dig Dis Sci. 1985;30:313–320. doi:10.​1007/​BF01403839.CrossRefPubMed
18.
go back to reference Shin HR, Won YJ, Jung KW, et al. Nationwide cancer incidence in Korea, 1999 2001; first result using the national cancer incidence database. Cancer Res Treat. 2005;37:325–331.CrossRefPubMed Shin HR, Won YJ, Jung KW, et al. Nationwide cancer incidence in Korea, 1999 2001; first result using the national cancer incidence database. Cancer Res Treat. 2005;37:325–331.CrossRefPubMed
21.
go back to reference Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney system. International workshop on the histopathology of gastritis, Houston 1994. Am J Surg Pathol. 1996;20:1161–1181.CrossRefPubMed Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney system. International workshop on the histopathology of gastritis, Houston 1994. Am J Surg Pathol. 1996;20:1161–1181.CrossRefPubMed
25.
go back to reference Wong BC, Lam SK, Wong WM, et al. China gastric cancer study group. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA. 2004;291:187–194. doi:10.1001/jama.291.2.187.CrossRefPubMed Wong BC, Lam SK, Wong WM, et al. China gastric cancer study group. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA. 2004;291:187–194. doi:10.​1001/​jama.​291.​2.​187.CrossRefPubMed
30.
go back to reference Samloff IM, Varis K, Ihamaki T, Siurala M, Rotter JI. Relationships among serum pepsinogen I, serum pepsinogen II and gastric mucosal histology: a study in relatives of patient with pernicious anemia. Gastroenterology. 1982;83:204–209.PubMed Samloff IM, Varis K, Ihamaki T, Siurala M, Rotter JI. Relationships among serum pepsinogen I, serum pepsinogen II and gastric mucosal histology: a study in relatives of patient with pernicious anemia. Gastroenterology. 1982;83:204–209.PubMed
31.
go back to reference Sitas F, Smallwood R, Jewell D, et al. Serum anti-Helicobacter pylori IgG antibodies and pepsinogens A and C as serological markers of chronic atrophic gastritis. Cancer Epidemiol Biomarkers Prev. 1993;2:119–123.PubMed Sitas F, Smallwood R, Jewell D, et al. Serum anti-Helicobacter pylori IgG antibodies and pepsinogens A and C as serological markers of chronic atrophic gastritis. Cancer Epidemiol Biomarkers Prev. 1993;2:119–123.PubMed
32.
go back to reference Miki K, Ichinose M, Kawamura N, et al. The significance of low serum pepsinogen levels to detect stomach cancer associated with extensive chronic gastritis in Japanese subjects. Jpn J Cancer Res. 1989;80:111–114.PubMed Miki K, Ichinose M, Kawamura N, et al. The significance of low serum pepsinogen levels to detect stomach cancer associated with extensive chronic gastritis in Japanese subjects. Jpn J Cancer Res. 1989;80:111–114.PubMed
Metadata
Title
The Correlation of Endoscopic and Histological Diagnosis of Gastric Atrophy
Authors
Alisher Eshmuratov
Jong Chun Nah
Nayoung Kim
Hye Seung Lee
Hee Eun Lee
Byoung Hwan Lee
Min Sik Uhm
Young Soo Park
Dong Ho Lee
Hyun Chae Jung
In Sung Song
Publication date
01-05-2010
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 5/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-009-0891-4

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