Gut Liver.  2013 Jan;7(1):41-50.

Correlation between Endoscopic and Histological Diagnoses of Gastric Intestinal Metaplasia

• Lim JH
• Kim N
• Lee HS
• Choe G
• Jo SY
• Chon I
• Choi C
• Yoon H
• Shin CM
• Park YS
• Lee DH
• Jung HC

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.

Keyword

Diagnosis; Endoscopy; Histology; Intestinal metaplasia

MeSH Terms

Atrophy
Biopsy
Endoscopy
Gastritis, Atrophic
Inflammation
Metaplasia
Multivariate Analysis
Stomach Ulcer