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Validation of MARK quadrant scoring system for early upper gastrointestinal endoscopy to detect gastric neoplasms in Chinese dyspeptic patients: A retrospective study
Author(s) -
Yu Adrian HoKun,
Cheung YauFung,
Leong HengTat
Publication year - 2019
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12369
Subject(s) - medicine , quadrant (abdomen) , retrospective cohort study , confidence interval , endoscopy , odds ratio , gastroenterology , outpatient clinic , biopsy , referral , surgery , family medicine
Aim Dyspepsia is a common reason for referral to the surgical outpatient department for consideration of upper gastrointestinal endoscopy. Patients at substantial risk of gastric neoplasm should be triaged for early endoscopy. The MARK quadrant scoring system is a new diagnostic tool to help predict the likelihood of gastric neoplasms in patients presenting with dyspepsia. The aim of the present study was to validate this tool in a surgical outpatient setting. Patients and Methods The present study involved a retrospective cohort of 604 patients at a local acute hospital in Hong Kong. Data were collected from the electronic health records for all first consultations at the surgical outpatient department for dyspepsia dating from 1 January to 31 December 2017. The MARK quadrant score was calculated and compared with upper gastrointestinal endoscopy findings and biopsy‐proven pathologies. Subgroup analysis for independent risk factors was performed. Results Fifty biopsy‐proven gastric neoplasms were identified, including 28 gastric adenocarcinomas, eight gastrointestinal stromal tumours, four gastric dysplasias and two gastric lymphomas. The area under the receiver‐operating characteristic curve was 0.954 [95 per cent confidence interval (CI): 0.908–0.999, P < 0.01]. At a cut‐off of 10, sensitivity was 90 per cent and specificity was 98.2 per cent. For subgroup analysis, male sex and smoking were positively associated with gastric neoplasms, with an odds ratio of 2.46 (95 per cent: CI 1.37–4.41, P < 0.01) and 2.60 (95 per cent CI: 1.36–4.98, P < 0.01), respectively. Conclusion The MARK quadrant score helps predict the likelihood of gastric neoplasms in dyspepsia. Male sex and smoking are independent risk factors of gastric neoplasms.