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. 2013 Jan;7(1):41-50.
doi: 10.5009/gnl.2013.7.1.41. Epub 2013 Jan 11.

Correlation between Endoscopic and Histological Diagnoses of Gastric Intestinal Metaplasia

Ji Hwan Lim  1 , Nayoung Kim, Hye Seung Lee, Gheeyoung Choe, So Young Jo, Ilyoung Chon, Chiun Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Hyun Chae Jung
Affiliations

Correlation between Endoscopic and Histological Diagnoses of Gastric Intestinal Metaplasia

Ji Hwan Lim et al. Gut Liver. 2013 Jan.

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: Diagnosis; Endoscopy; Histology; Intestinal metaplasia.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The description of the biopsy sites. Histology and cultures were performed on the two specimens A and C, each from the antrum, and on the two specimens B and D, each from the body. In addition, rapid urease testing was performed on one specimen each from C and D. A, the greater curvature of mid antrum; B, the greater curvature of mid body; C, the lesser curvature of mid antrum; D, the lesser curvature of mid body.
Fig. 2
Fig. 2
The prevalence of endoscopic intestinal metaplasia (IM) (A) and histological IM (B) depending on age. Both endoscopic and histological IM increased proportionally with age (p<0.001). However, there was no significant increase in histological IM, which was found only in the body.
See this image and copyright information in PMC

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