Detection of gastric precancerous conditions in daily clinical practice: a nationwide survey

Edith Lahner, Angelo Zullo, Cesare Hassan, Francesco Perri, Mário Dinis-Ribeiro, Gianluca Esposito, Emilio Di Giulio, Elisabetta Buscarini, Maria A ntonietta Bianco, Michele De Boni, Bruno Annibale

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)417-424
Number of pages8
JournalHelicobacter
Volume19
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Precancerous Conditions
Stomach
Metaplasia
Atrophy
Biopsy
Gastrointestinal Endoscopy
Italy
Stomach Neoplasms
Surveys and Questionnaires
Histology
Guidelines
Pathology

Keywords

  • gastric atrophy
  • Gastric cancer
  • guidelines adherence
  • intestinal metaplasia
  • Sydney system

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lahner, E., Zullo, A., Hassan, C., Perri, F., Dinis-Ribeiro, M., Esposito, G., ... Annibale, B. (2014). Detection of gastric precancerous conditions in daily clinical practice: a nationwide survey. Helicobacter, 19(6), 417-424. https://doi.org/10.1111/hel.12149

Detection of gastric precancerous conditions in daily clinical practice : a nationwide survey. / Lahner, Edith; Zullo, Angelo; Hassan, Cesare; Perri, Francesco; Dinis-Ribeiro, Mário; Esposito, Gianluca; Di Giulio, Emilio; Buscarini, Elisabetta; Bianco, Maria A ntonietta; De Boni, Michele; Annibale, Bruno.

In: Helicobacter, Vol. 19, No. 6, 01.12.2014, p. 417-424.

Research output: Contribution to journalArticle

Lahner, E, Zullo, A, Hassan, C, Perri, F, Dinis-Ribeiro, M, Esposito, G, Di Giulio, E, Buscarini, E, Bianco, MAN, De Boni, M & Annibale, B 2014, 'Detection of gastric precancerous conditions in daily clinical practice: a nationwide survey', Helicobacter, vol. 19, no. 6, pp. 417-424. https://doi.org/10.1111/hel.12149
Lahner E, Zullo A, Hassan C, Perri F, Dinis-Ribeiro M, Esposito G et al. Detection of gastric precancerous conditions in daily clinical practice: a nationwide survey. Helicobacter. 2014 Dec 1;19(6):417-424. https://doi.org/10.1111/hel.12149
Lahner, Edith ; Zullo, Angelo ; Hassan, Cesare ; Perri, Francesco ; Dinis-Ribeiro, Mário ; Esposito, Gianluca ; Di Giulio, Emilio ; Buscarini, Elisabetta ; Bianco, Maria A ntonietta ; De Boni, Michele ; Annibale, Bruno. / Detection of gastric precancerous conditions in daily clinical practice : a nationwide survey. In: Helicobacter. 2014 ; Vol. 19, No. 6. pp. 417-424.
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abstract = "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.",
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AU - Esposito, Gianluca

AU - Di Giulio, Emilio

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AU - De Boni, Michele

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N2 - 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.

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