Gut and Liver

The Korean Association for the Study of the Liver (대한간학회)
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Correlation between Endoscopic and Histological Diagnoses of Gastric Intestinal Metaplasia

  • Lim, Ji Hwan (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Nayoung (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lee, Hye Seung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Choe, Gheeyoung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Jo, So Young (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Chon, Ilyoung (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Choi, Chiun (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Yoon, Hyuk (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Shin, Cheol Min (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Park, Young Soo (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Dong Ho (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jung, Hyun Chae (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
  • Published : 2013.01.15
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Abstract

Background/Aims: Intestinal metaplasia (IM) is a premalignant condition. This study aimed to evaluate the correlation between endoscopic and histological findings of IM. Methods: The cases of IM were graded by conventional endoscopy, and biopsies were taken from the antrum and body of 1,333 subjects for histological IM diagnosis. Multivariate analyses were performed to identify the factors that affect the sensitivity of endoscopic IM diagnosis. Results: The sensitivity/specificity of endoscopic IM diagnosis based on histology was 24.0%/91.9% for the antrum and 24.2%/88.0% for the body. As indicated by multivariate analysis, the presence of endoscopic atrophic gastritis (AG) (odds ratio [OR], 4.73; 95% confidence interval [CI], 2.07 to 10.79) and the activity of mucosal inflammation (OR, 2.21; 95% CI, 1.08 to 4.54) were associated with the sensitivity of endoscopic IM diagnosis in the antrum, while the presence of endoscopic AG (OR, 8.02; 95% CI, 4.55 to 14.15), dysplasia (OR, 2.40; 95% CI, 1.07 to 5.39), and benign gastric ulcers (OR, 0.35; 95% CI, 0.15 to 0.081) were associated with the sensitivity of endoscopic IM diagnosis in the body. Conclusions: As the sensitivity of endoscopic IM diagnosis was low, a high index of suspicion for IM is necessary in the presence of atrophy, and confirmation by histology is also necessary.

Keywords

References

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