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 Sydney 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 Sydney 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 Sydney 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 Sydney system showing that international guidelines are poorly observed in clinical practice. This may represent a critical element for surveillance strategies for gastric cancer.
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 Sydney 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 dyspepticpatients. 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 Sydney 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 Sydney 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 Sydney system showing that international guidelines are poorly observed in clinical practice. This may represent a critical element for surveillance strategies for gastric cancer.
Authors: Guido Costamagna; Angelo Zullo; Alessandra Bizzotto; Cristiano Spada; Cesare Hassan; Maria Elena Riccioni; Clelia Marmo; Giuseppe Strangio; Teresa Antonella Di Rienzo; Giovanni Cammarota; Antonio Gasbarrini; Alessandro Repici Journal: United European Gastroenterol J Date: 2015-10-13 Impact factor: 4.623
Authors: Osama Altayar; Perica Davitkov; Shailja C Shah; Andrew J Gawron; Douglas R Morgan; Kevin Turner; Reem A Mustafa Journal: Gastroenterology Date: 2019-12-06 Impact factor: 22.682
Authors: M Cazzato; G Esposito; G Galli; E Pilozzi; E Lahner; V D Corleto; A Zullo; E Di Giulio; B Annibale Journal: Gastroenterol Res Pract Date: 2021-03-20 Impact factor: 2.260
Authors: Elisabeth Scheidl; Claus Benz; Peter Loeff; Volker Groneck; Andreas König; Alban Schulte-Fischedick; Hendrik Lück; Uwe Fuhr Journal: Drugs R D Date: 2020-06