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DOI: 10.1055/s-0041-1724410
Accuracy of Endoscopic Diagnosis in Gastric Precancerous Conditions
Aims Atrophic gastritis (AG) and intestinal metaplasia (IM) are gastric precancerous conditions (GPC), which are key points in risk stratification for development of intestinal type gastric cancer. The aim of this study was to investigate a performance of endoscopic detection of GPC.
Methods It was a multicenter, retrospective study. Out of 6277 patients who underwent diagnostic gastroscopy from 03.2018 to 10.2019 in three centers (tertiary university center, local hospital and private out-patient center) 2078 who had obtained biopsy to evaluate gastritis were analyzed.
Results Endoscopic diagnosis of gastritis was established in 2026 patients and in 917 patients AG or IM were detected endoscopically. General GPC detection accuracy (ACC) was 0.64. Endoscopic detection ACC of IM and AG were similar but AG detection characterized with higher sensitivity and lower specificity than IM detection. The data has been summarized in [table 1]. 91 patients were diagnosed with an advance stage of AG based on MAPS II guidelines criteria. Gastritis was diagnosed endoscopically in 89 patients (98 %) and only in 64 ones (70 %) GPC was endoscopically detected. In the multivariate logistic regression no factor such as sedation, inpatient procedure, HD endoscope, endoscopic detection of gastritis or operator with high biopsy rate was found as factor influencing detection of advanced stages of AG. In the single variate regression model endoscopically visualized AG increased over 2-folds (OR 2.2; 95 % CI 1.4-3.5), and IM over 3-folds (OR 3.4; 95 % CI 1.9-5.9) the risk of advanced stages of AG of detection.
Variable |
Sensitivity |
Specificity |
Accuracy |
---|---|---|---|
GPC |
0.58 |
0.68 |
0.64 |
AG |
0.70 |
0.67 |
0.68 |
IM |
0.19 |
0.98 |
0.71 |
Conclusions Despite improvements in endoscopy technology the detection accuracy of GPC is still too low to substitute biopsy. Obtaining patients biopsy with any sign of gastritis could decrease number of biopsies. This observation warrants further research.
Citation: Romańczyk M, Ostrowski B, Budzyń K et al. OP153 ACCURACY OF ENDOSCOPIC DIAGNOSIS IN GASTRIC PRECANCEROUS CONDITIONS. Endoscopy 2021; 53: S62.
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Publikationsverlauf
Artikel online veröffentlicht:
19. März 2021
© 2021. European Society of Gastrointestinal Endoscopy. All rights reserved.
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