title: Comparison between serology and histology in the diagnosis of advanced gastric body atrophy: a study in a Dutch primary community.
abstract: OBJECTIVE
  To assess serologically diagnosed gastric body atrophy (GBA) by histology in a sample of the general population.
  
  
  BACKGROUND
  GBA is a precursor lesion in gastric cancer. Data on GBA in a primary health care community in the Netherlands have not been reported.
  
  
  METHODS
  Thirty-four subjects of 997 consecutive adults from a Dutch family practice had serologic GBA, according to hypergastrinemia (>100 ng/L), hypopepsinogenemia A (<17 microg/L), and a low pepsinogen A/C ratio (<1.6). Two years later, 25 subjects of this group, agreed in serologic retesting and gastroscopy with biopsies for histologic assessment according to the Sydney system.
  
  
  RESULTS
  At serologic retesting, 20 of 25 subjects again fulfilled the serologic criteria of GBA. Histologic examination of the corpus biopsies showed advanced GBA in 18 subjects (75%) of 24 (1 subject had no corpus biopsies) and 17 of 19 (89%) subjects with repeated positive serology. After disclosure of serology results, reexamination of the biopsies revealed GBA also in the 2 patients with initially insufficient evidence of GBA, giving a concordance of 100% (19/19). One subject with normal serum gastrin at retesting had both antral and body atrophy giving a concordance between serologic and histologic GBA of 95% (19/20). No adenomatous polyps, tumors, or dysplastic alterations were found.
  
  
  CONCLUSIONS
  Identification by serology of asymptomatic patients with advanced GBA in primary care is adequately possible and useful in selecting for endoscopy.
authors: Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands.
authors: André
authors: A
authors: Korstanje
authors: Susanne
authors: S
authors: van Eeden
authors: Johan A
authors: JA
authors: Offerhaus
authors: Frans L
authors: FL
authors: Waltman
authors: Gijsbert den
authors: Gd
authors: Hartog
authors: Freek W C
authors: FW
authors: Roelandse
authors: John H M
authors: JH
authors: Souverijn
authors: Izak
authors: I
authors: Biemond
authors: Cornelis B H W
authors: CB
authors: Lamers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001284:Atrophy / Q000473:pathology; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000453:epidemiology; D001706:Biopsy; D002908:Chronic Disease; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D005748:Gastric Fundus / Q000473:pathology; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000097:blood / Q000175:diagnosis*; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010435:Pepsinogens / Q000097:blood; D015995:Prevalence; D011706:Pyloric Antrum / Q000473:pathology; D012698:Serologic Tests
chemical_list: D000907:Antibodies, Bacterial; D001323:Autoantibodies; D005755:Gastrins; D010435:Pepsinogens