Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading

被引:341
作者
Rugge, M
Correa, P
Dixon, MF
Fiocca, R
Hattori, T
Lechago, J
Leandro, G
Price, AB
Sipponen, P
Solcia, E
Watanabe, H
Genta, RM
机构
[1] Univ Padua, Dept Oncol & Surg Sci, Padua, Italy
[2] Louisiana State Univ, Ctr Hlth Sci, New Orleans, LA USA
[3] Univ Leeds, Dept Pathol, Gen Infirm, Leeds, W Yorkshire, England
[4] Gen Infirm, Ctr Digest Dis, Leeds, W Yorkshire, England
[5] Univ Genoa, Dept Pathol, Genoa, Italy
[6] Shiga Univ Med Sci, Dept Pathol, Otsu, Shiga, Japan
[7] Methodist Hosp, Dept Pathol, Baylor Coll Med, Houston, TX 77030 USA
[8] De Bellis Gastroenterol Hosp, Bari, Italy
[9] Jorvi Hosp, Dept Pathol, SF-02740 Espoo, Finland
[10] Univ Pavia, IRCCS, Policlin San Matteo, Dept Human Pathol, I-27100 Pavia, Italy
[11] Niigata Univ, Sch Med, Dept Pathol 1, Niigata, Japan
[12] Baylor Coll Med, Vet Affairs Med Ctr, Dept Pathol, Houston, TX 77030 USA
关键词
D O I
10.1046/j.1365-2036.2002.01301.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Considerable difficulties persist amongst pathologists in agreeing on the presence and severity of gastric atrophy. An international group of pathologists pursued the following aims: (i) to generate an acceptable definition and a simple reproducible classification of gastric atrophy; and (ii) to develop guidelines for the recognition of atrophy useful for increasing agreement among observers. Methods: After redefining atrophy as the 'loss of appropriate glands' and examining histological samples from different gastric compartments, three categories were identified: (i) negative; (ii) indefinite; (iii) atrophy, with and without intestinalization. Atrophy was graded on a three-level scale. Interobserver reproducibility of the classification was tested by kappa statistics (general and weighted) in a series of 48 cases. Results: The medians of the general agreement and weighted kappa values were 0.78 and 0.73, respectively. The weighted kappa coefficients, obtained by cross-tabulating the evaluation of each pathologist against all others, were, with only one exception, > 0.4 (moderate to excellent agreement). Conclusions: By using the definition of atrophy as the loss of appropriate glands and distinguishing the two main morphological entities of metaplastic and non-metaplastic types, a high level of agreement was achieved by a group of gastrointestinal pathologists trained in different cultural contexts.
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页码:1249 / 1259
页数:11
相关论文
共 46 条
[31]   Observer agreement on the grading of gastric atrophy [J].
Offerhaus, GJA ;
Price, AB ;
Haot, J ;
ten Kate, FJW ;
Sipponen, P ;
Fiocca, R ;
Stolte, M ;
Dixon, MF .
HISTOPATHOLOGY, 1999, 34 (04) :320-325
[32]   NORMAL HISTOLOGY OF THE STOMACH [J].
OWEN, DA .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1986, 10 (01) :48-61
[33]   THE SYDNEY SYSTEM - HISTOLOGICAL DIVISION [J].
PRICE, AB .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 1991, 6 (03) :209-222
[34]   Gastric dysplasia - The Padova international classification [J].
Rugge, M ;
Correa, P ;
Dixon, MF ;
Hattori, T ;
Leandro, G ;
Lewin, K ;
Riddell, RH ;
Sipponen, P ;
Watanabe, H .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2000, 24 (02) :167-176
[35]   Helicobacter pylori in promotion of gastric carcinogenesis [J].
Rugge, M ;
Cassaro, M ;
Leandro, G ;
Baffa, R ;
Avellini, C ;
Bufo, P ;
Stracca, V ;
Battaglia, G ;
Fabiano, A ;
Guerini, A ;
DiMario, F .
DIGESTIVE DISEASES AND SCIENCES, 1996, 41 (05) :950-955
[36]   Morphometric assessment of gastric antral atrophy: comparison with visual evaluation [J].
Ruiz, B ;
Garay, J ;
Johnson, W ;
Li, D ;
Rugge, M ;
Dixon, MF ;
Fiocca, R ;
Genta, RM ;
Hattori, T ;
Lechago, J ;
Price, AB ;
Sipponen, P ;
Solcia, E ;
Watanabe, H ;
Correa, P .
HISTOPATHOLOGY, 2001, 39 (03) :235-242
[37]  
Satoh K, 1998, AM J GASTROENTEROL, V93, P569
[38]   An evidence-based approach to gastroenterology diagnosis [J].
Schoenfeld, P ;
Guyatt, G ;
Hamilton, F ;
Laine, L ;
Cook, D ;
Bjorkman, D ;
Morgan, D ;
Peterson, W .
GASTROENTEROLOGY, 1999, 116 (05) :1230-1237
[39]   Clinical impact of routine biopsies of the gastric antrum and body [J].
Sipponen, P ;
Stolte, M .
ENDOSCOPY, 1997, 29 (07) :671-678
[40]  
Solcia E, 1996, AM J SURG PATHOL, V20, pS8