title: Correlations among endoscopic, histologic and serologic diagnoses for the assessment of atrophic gastritis.
abstract: BACKGROUND
  Atrophic gastritis is a precancerous condition, which can be diagnosed by several methods. However, there is no consensus for the standard method. The aim of this study was to evaluate the correlations among endoscopic, histologic, and serologic findings for the diagnosis of atrophic gastritis.
  
  
  METHODS
  From March 2003 to August 2013, a total of 2,558 subjects were enrolled. Endoscopic atrophic gastritis was graded by Kimura-Takemoto classification and histological atrophic gastritis was assessed by updated Sydney system. Serological assessment of atrophic gastritis was based on serum pepsinogen test.
  
  
  RESULTS
  The serum pepsinogen I/II ratio showed a significant decreasing nature when the extent of atrophy increased (R(2)=0.837, P<0.001) and the cut-off value for distinguishing between presence and absence of endoscopic atrophic gastritis was 3.2. The serum pepsinogen I and pepsinogen I/II ratio were significantly lower when the histological atrophic gastritis progressed and the cut-off value was 3.0 for a diagnosis of histological atrophic gastritis. A significant correlation between endoscopic and histological atrophic gastritis was noted and the sensitivity and specificity of endoscopic diagnosis were 65.9% and 58.0% for antrum, 71.3% and 53.7% for corpus, respectively.
  
  
  CONCLUSIONS
  The endoscopic, histological, and serological atrophic gastritis showed relatively good correlations. However, as these three methods have a limitation, a multifactorial assessment might be needed to ameliorate the diagnostic accuracy of atrophic gastritis.
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Ju Yup
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam ; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.affiliation: Pathology, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Yonsei Plus Clinic, Seongnam, Korea.
authors.forename: Jane C
authors.initials: JC
authors.lastname: Oh
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Kwon
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Yoon Jin
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Ki Chul
authors.initials: KC
authors.lastname: Yoon
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Jae Jin
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: AeRa
authors.initials: A
authors.lastname: Lee
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Yeonsang
authors.initials: Y
authors.lastname: Jeong
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Jo
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Hyuk
authors.initials: H
authors.lastname: Yoon
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Shin
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam ; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
keywords: Atrophic gastritis; Endoscopy; Histology; Pepsinogen