Comparison between serology and histology in the diagnosis of advanced gastric body atrophy: a study in a Dutch primary community.
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.
Korstanje
André
A
Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands.
van Eeden
Susanne
S
Offerhaus
Johan A
JA
Waltman
Frans L
FL
Hartog
Gijsbert den
Gd
Roelandse
Freek W C
FW
Souverijn
John H M
JH
Biemond
Izak
I
Lamers
Cornelis B H W
CB
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
D000907:Antibodies, Bacterial; D001323:Autoantibodies; D005755:Gastrins; D010435:Pepsinogens