TY - JOUR
T1 - Histological assessment of gastric pseudopyloric metaplasia
T2 - Intra- and inter-observer consistency
AU - Rugge, Massimo
AU - Sacchi, Diana
AU - Genta, Robert M.
AU - Zanco, Francesca
AU - Guzzinati, Stefano
AU - Pizzi, Marco
AU - Fassan, Matteo
AU - Sabatino, Antonio Di
AU - El-Serag, Hashem
PY - 2020
Y1 - 2020
N2 - Background: The histological spectrum of oxyntic mucosal atrophy (a major determinant of gastric cancer risk) includes pseudopyloric metaplasia (PPM), which histological assessment has been regarded as unreliable. PPM consistently expresses Trefoil-Factor 2 (TFF2), which is histochemically detecteble (TFF2-IHC). Aims: Intra- and inter-observer consistency in assessing PPM was examined using both hematoxylin & eosin (H&E) and TFF2-IHC. Materials and methods: Seventy-four oxyntic biopsy samples obtained from autoimmune gastritis were considered. Two serial histological sections obtained from the paraffin-embedded tissue-samples were stained with H&E and TFF2-IHC. Three pathologists (Alpha, Beta, Gamma) independently scored PPM by both staining and the Intra- and inter-observer consistency (H&E versus TFF2-IHC) was calculated using k-statistics and/or Spearman's coefficient. Results: Based on H&E-stain versus TFF2-IHC, intra-observer consistency in PPM assessement was ranked as consistently “good” (k-values: Alpha=0.79; Beta=0.78; Gamma=0.75). Based on H&E, the overall PPM inter-observer consistency among the 3 observers was ranked as “good” (k=0.77) (the inter-observer consistency for pairs of observers was as follows: Alpha versus Beta k=0.88; Alpha versus Gamma k=0.87; Beta versus Gamma k=0.80). Based on TFF2-IHC, the overall PPM inter-observer agreement was ranked as “excellent” (k=0.91) (the inter-observer consistency for pairs of observers was as follows: Alpha versus Beta k=1; Alpha versus Gamma k=0.91; Beta versus Gamma k=0.91). Conclusion: Relying on either H&E staining or TFF2-IHC, pathologists assess PPM consistently.
AB - Background: The histological spectrum of oxyntic mucosal atrophy (a major determinant of gastric cancer risk) includes pseudopyloric metaplasia (PPM), which histological assessment has been regarded as unreliable. PPM consistently expresses Trefoil-Factor 2 (TFF2), which is histochemically detecteble (TFF2-IHC). Aims: Intra- and inter-observer consistency in assessing PPM was examined using both hematoxylin & eosin (H&E) and TFF2-IHC. Materials and methods: Seventy-four oxyntic biopsy samples obtained from autoimmune gastritis were considered. Two serial histological sections obtained from the paraffin-embedded tissue-samples were stained with H&E and TFF2-IHC. Three pathologists (Alpha, Beta, Gamma) independently scored PPM by both staining and the Intra- and inter-observer consistency (H&E versus TFF2-IHC) was calculated using k-statistics and/or Spearman's coefficient. Results: Based on H&E-stain versus TFF2-IHC, intra-observer consistency in PPM assessement was ranked as consistently “good” (k-values: Alpha=0.79; Beta=0.78; Gamma=0.75). Based on H&E, the overall PPM inter-observer consistency among the 3 observers was ranked as “good” (k=0.77) (the inter-observer consistency for pairs of observers was as follows: Alpha versus Beta k=0.88; Alpha versus Gamma k=0.87; Beta versus Gamma k=0.80). Based on TFF2-IHC, the overall PPM inter-observer agreement was ranked as “excellent” (k=0.91) (the inter-observer consistency for pairs of observers was as follows: Alpha versus Beta k=1; Alpha versus Gamma k=0.91; Beta versus Gamma k=0.91). Conclusion: Relying on either H&E staining or TFF2-IHC, pathologists assess PPM consistently.
KW - Atrophic gastritis
KW - Autoimmune gastritis
KW - PPM
KW - Pseudopyloric metaplasia
KW - SPEM
UR - http://www.scopus.com/inward/record.url?scp=85091812626&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091812626&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2020.09.003
DO - 10.1016/j.dld.2020.09.003
M3 - Article
AN - SCOPUS:85091812626
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
ER -