title: Gela histological scoring system for post-treatment biopsies of patients with gastric MALT lymphoma is feasible and reliable in routine practice.
abstract: The International Extranodal Lymphoma Study Group (IELSG) promoted this study to determine the inter-observer agreement in the application of the Groupe d' Etude des Lymphomes de l' Adulte (GELA) histological scoring system for evaluating residual disease in post-treatment gastric biopsies of patients with gastric Mucosa-Associated Lymphoid Tissue (MALT) lymphoma (GML). Twenty-one patients with Helicobacter pylori -associated GML and treated with anti-H. pylori therapies were considered. A total of 154 biopsy sets from follow-up endoscopic procedures after H. pylori eradication were examined independently by seven pathologists from four European countries, following histological criteria suggested by the GELA scoring system. The overall concordance rate was 83% with a kappa value of 0·64, indicating a significant agreement among the seven observers. Most non-concordant responses clustered across the border of complete remission (CR) and probable minimal residual disease (pMRD), a distinction that does not imply critical clinical impact. Accordingly, when the analysis considered CR/pMRD as a single entity, the responses showed an overall concordance rate of 89% with kappa value of 0·83, thus indicating a high degree of inter-observer agreement. This study provides additional validation of the GELA histological grading system. This scheme can therefore be recommended in routine practice and deserves to be used in prospective clinical trials.
authors.affiliation: AP-HP, Groupe Henri Mondor-Albert Chenevier, Département de Pathologie, Créteil, France. christiane.copie@hmn.aphp.fr
authors.forename: Christiane
authors.initials: C
authors.lastname: Copie-Bergman
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Wotherspoon
authors.forename: Carlo
authors.initials: C
authors.lastname: Capella
authors.forename: Teresio
authors.initials: T
authors.lastname: Motta
authors.forename: Ennio
authors.initials: E
authors.lastname: Pedrinis
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Pileri
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertoni
authors.forename: Annarita
authors.initials: A
authors.lastname: Conconi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Zucca
authors.forename: Maurilio
authors.initials: M
authors.lastname: Ponzoni
authors.forename: Andrés J M
authors.initials: AJ
authors.lastname: Ferreri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index