Diagnostic accuracy of nodular gastritis for H. pylori infection
Authors Romero-Flores JL, Fernandez-Rivero JA, Marroquín-Fabian E, Téllez-Avila FI, Sánchez-Jiménez BA, Juárez-Hernández E, Uribe M, Chávez-Tapia NC
Received 7 September 2016
Accepted for publication 29 October 2016
Published 16 December 2016 Volume 2017:13 Pages 9—14
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Garry Walsh
Juan L Romero-Flores,1 Justo A Fernandez-Rivero,1 Erika Marroquín-Fabian,1 Félix I Téllez-Ávila,2 Beatriz A Sánchez-Jiménez,1 Eva Juárez-Hernández,3 Misael Uribe,1 Norberto C Chávez-Tapia1,3
1Obesity and Digestive Diseases Unit, Medica Sur Clinic & Foundation, 2Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 3Translational Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
Background: The term nodular is not included in the Sydney classification and there is no widely accepted histopathological definition. It has been proposed that the presence of antral nodularity could predict Helicobacter pylori (H. pylori) infection. The aim of this study was to determine the diagnostic accuracy of nodular gastritis (NG) for H. pylori infection after a rigorous standardization process, and to describe the associated histopathological characteristics.
Materials and methods: Endoscopic images of patients submitted to endoscopy with biopsy sampling were included. Endoscopic images were distributed among six endoscopists. The analysis was performed sequentially in three rounds: the first round assessed the interobserver variability, the second evaluated the intraobserver variability, and the third calculated the interobserver variability after training. A correlation analysis between endoscopic and histopathological findings was performed.
Results: A total of 917 studies were included. In the first analysis of interobserver variability, a poor kappa value (0.078) was obtained. The second evaluation yielded good intraobserver variability, with kappa values of 0.62–0.86. The evaluation of interobserver variability after training revealed an improvement in the kappa value of 0.42. A correlation was found between endoscopic images and histopathological reports.
Conclusion: There was a strong correlation between NG and H. pylori, but only after rigorous evaluation. The use of the term NG requires extensive standardization before it can be used clinically.
Keywords: sensitivity, specificity, endoscopy, histopathologic
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