Interobserver and intraobserver agreement for gastric mucosa atrophy.
Interobserver and intraobserver agreement for gastric mucosa atrophy.
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DOI：
10.1186/s12876-015-0327-x
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发表时间：
2015-08-04
影响因子：
2.4
通讯作者：
Chayama K
中科院分区：
文献类型：
--
作者：
Miwata T;Quach DT;Hiyama T;Aoki R;Le HM;Tran PL;Ito M;Tanaka S;Arihiro K;Uemura N;Chayama K
幽门螺杆菌（H.幽门螺杆菌感染与胃癌的风险密切相关，尤其是肠型胃癌。观察者间和观察者内对H.研究了未感染幽门螺杆菌、目前感染和过去感染的幽门螺杆菌。评估了91例患者的内镜图像，每例患者34张图像。评估者为4个内镜医师组：日本和越南经验组（内镜经验≥7，≤ 15年）以及日本和越南初学者组（内镜经验≤ 3年）。每组由3名内镜医生组成。采用Kimura-Takemoto分类法将萎缩分级分为3级：无至轻度（C-0和C-1）、中度（C-2和C-3）和重度（O-1、O-2和O-3）。2周后，研究人员重新评估所有患者的图像。观察者间和观察者内一致性通过kappa统计计算。日本和越南经验组，日本和越南初学者组的观察者间一致性的Kappa值分别为0.474，0.408，0.291和0.373。日本和越南经验丰富的内镜医师的观察者内一致性的Kappa值范围为0.585至0.871。另一方面，初学者的值范围比经验丰富的内窥镜医生更宽，从0.264到0.866。我们的研究结果表明，虽然观察者对胃粘膜萎缩的一致性是好到极好的，但在有经验的内镜医师中，观察者之间的一致性是中等的。这表明可能需要更好的指南和严格的标准来正确诊断和分级胃萎缩。
The grade of gastric mucosa atrophy caused by Helicobacter pylori (H. pylori) infection is closely associated with the risk of gastric cancer, especially of the intestinal type. Interobserver and intraobserver agreement for endoscopic gastric mucosa atrophy in subjects with H. pylori-uninfected, currently infected and past infected was investigated. Endoscopic images of 91 patients, 34 images per patient, were assessed. The assessors were 4 endoscopist groups: Japanese and Vietnamese experienced (≥7, ≤ 15 year experience with endoscopy) and Japanese and Vietnamese beginner (≤ 3 year experience) groups. Each group comprised 3 endoscopists. The grades of atrophy were classified as 3: none to mild (C-0 and C-1), moderate (C-2 and C-3), and severe (O-1, O-2, and O-3) using the Kimura-Takemoto Classification. After a period of 2 weeks, images of all patients were reevaluated by the investigators. Interobserver and intraobserver agreement was calculated by kappa statistics. The kappa values for the interobserver agreement in the groups of Japanese and Vietnamese experienced, and Japanese and Vietnamese beginner were 0.474, 0.408, 0.291, and 0.373, respectively. The kappa value of intraobsever agreement in the Japanese and Vietnamese experienced endoscoists ranged from 0.585 to 0.871. On the other hand, the value in the beginner endoscopists ranged wider than that in experienced endoscopists, from 0.264 to 0.866. Our results indicated that, although intraobserver agreement for gastric mucosa atrophy was good to excellent, interobserver agreement was moderate in experienced endoscopists. This suggests that better guidelines and firm criteria may be needed to properly diagnose and grade gastric atrophy.