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- Title
Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading.
- Authors
Rugge, M.; Correa, P.; Dixon, M. F.; Fiocca, R.; Hattori, T.; Lechago, J.; Leandro, G.; Price, A. B.; Sipponen, P.; Solcia, E.; Watanabe, H.; Genta, R. M.
- Abstract
Summary Background and aims : 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 κ statistics (general and weighted) in a series of 48 cases. Results : The medians of the general agreement and weighted κ values were 0.78 and 0.73, respectively. The weighted κ 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.
- Subjects
GASTRIC mucosa; NEUROMUSCULAR diseases
- Publication
Alimentary Pharmacology & Therapeutics, 2002, Vol 16, Issue 7, p1249
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1046/j.1365-2036.2002.01301.x