Hit or a miss: Concordance between histopathologic-endoscopic findings in gastric mucosal biopsies |
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| Affiliation: | 1. Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States of America;2. Department of Pathology, University of Washington Medical Center, Seattle, WA, United States of America;3. College of Medicine, Penn State Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA, United States of America;4. Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States of America;1. Faculty of Science, University of Oradea, Oradea 410087, Romania;2. School of Physical Sciences, The University of Adelaide, Adelaide SA 5005, Australia;1. University of Medicine and Pharmacy, Clinical Science-Internal Medicine, Tirgu Mureș, Gheorghe Marinescu 38, 540139, Romania;2. University of Medicine and Pharmacy “Iuliu Hațieganu”, Department of Medical Informatics and Biostatistics, Louis Pasteur St, no. 6, 400349 Cluj-Napoca, Romania;3. Emergency County Hospital, Pathological Department, Tirgu Mures, Gheorghe Marinescu 50, 540136 Mures, Romania;4. University of Medicine and Pharmacy, Department of Morphological Science, Genetic, Tirgu Mureș, Gheorghe Marinescu 38, 540139, Romania;5. Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, University of Medicine and Pharmacy, Tirgu Mureș, Gheorghe Marinescu 38, 540139 Mures, Romania |
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| Abstract: | BackgroundCurrent literature shows a variable degree of concordance between endoscopic and histopathologic findings in gastric mucosal biopsies. Most prior studies have focused on specific gastric entities such as gastritis in patients with high prevalence of Helicobacter pylori (H. pylori). In this study, we assess concordance between histologic and endoscopic findings in a wide spectrum of targeted as well as non-targeted gastric endoscopic biopsies.MethodsWe retrospectively reviewed pathology database and slides at Hershey Medical Center to identify 630 gastric mucosal biopsies obtained from 525 consecutive patients. The corresponding clinical and endoscopic findings were retrieved from the electronic medical record.ResultsThe rate of abnormal endoscopic and histologic findings was 72.9% and 74.4%, respectively, with Cohen's ĸ coefficient of 0.24. There were 444 (70.5%) concordant cases and 186 (29.5%) discordant cases (88 cases with abnormal endoscopy but normal histology, and 98 cases with normal endoscopy but abnormal histology). Some endoscopic findings, in particular, mass, polyp, ulcer, and nodule/papule were highly concordant with abnormal histopathologic findings; while other endoscopic findings such as inflammatory changes, normal and prominent folds were associated with normal and a variety of abnormal histopathology. Multivariate analysis showed no significant association between intestinal metaplasia and H. pylori in this study.ConclusionsHistopathologic-endoscopic correlation in gastric biopsies varies depending on endoscopic mucosal patterns. Intestinal metaplasia may not have a significant association with H. pylori infection in populations with low prevalence of H. pylori. |
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