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Detection of Gastric Precancerous Conditions in Daily Clinical Practice: A Nationwide Survey
Author(s) -
Lahner Edith,
Zullo Angelo,
Hassan Cesare,
Perri Francesco,
DinisRibeiro Mário,
Esposito Gianluca,
Di Giulio Emilio,
Buscarini Elisabetta,
Bianco Maria Antonietta,
De Boni Michele,
Annibale Bruno
Publication year - 2014
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12149
Subject(s) - histopathology , intestinal metaplasia , medicine , gastroenterology , atrophy , metaplasia , endoscopy , biopsy , clinical practice , stomach , pathology , physical therapy
Background The burden of gastric precancerous conditions and factors associated with their detection have not been fully investigated in community‐based settings. Little is known about adherence to S ydney system for histopathology of gastric biopsies. Objective We aimed to investigate what really happens in clinical practice with regard to the detection of gastric atrophy and intestinal metaplasia in dyspeptic patients. Methods We performed a nationwide survey of 979 consecutive patients (50–65 years old) with dyspeptic symptoms, examined at 24 gastrointestinal endoscopy units throughout Italy. Clinical information was collected from questionnaires; a standard bioptic mapping was performed in each unit, biopsies from each patient were analyzed by histopathology performed according to daily clinical practice in each local histopathology center. Results Separate descriptions of antral and corporal biopsies were included in 679 pathology reports (69%), whereas S ydney system was applied in 324 reports (33%). Gastric atrophy without intestinal metaplasia ( GA ) and gastric atrophy with intestinal metaplasia ( GIM ) were detected in 322 (33%) patients. The full adherence to S ydney system significantly increased the probability of detecting GIM ( OR 9.6, 95% CI 5.5–16.7), GA ( OR 1.92, 95% CI 1.07–3.44), and either of the conditions ( OR 6.67, 95% CI 4.36–10.19). Conclusions This nationwide survey showed that in one‐third of dyspeptic patients, gastric precancerous conditions are detected. In daily routine practice, only 1/3 of histology reports were worked out adhering to S ydney system showing that international guidelines are poorly observed in clinical practice. This may represent a critical element for surveillance strategies for gastric cancer.