期刊
DIGESTIVE AND LIVER DISEASE
卷 53, 期 1, 页码 61-65出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2020.09.003
关键词
Pseudopyloric metaplasia; PPM; SPEM; Atrophic gastritis; Autoimmune gastritis
资金
- Italian Association for Cancer Research (AIRC) [6421]
- Italian Health Ministry [NET-2016-02363853]
This study found that pathologists consistently assessed PPM whether using H&E staining or TFF2-IHC. The agreement among observers may be higher when assessing PPM based on TFF2-IHC.
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. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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