Elmas KASAP, Gökçen GÜNGÖR, Emine AYGÖR, Özlem Suade BADAK, Semin AYHAN, Hakan YÜCEYAR

Üst gastrointestinal mukozayı değerlendirmede endoskopistler ve patologlar ne kadar uyumludur?

Giriş ve Amaç: Çalışmanın amacı endoskopist ve patologların üst gastroin testinal mukoza tanıları arasındaki uyumu araştırmak ve endoskopik ve patolojik tanılara göre Helikobakter pilori sıklığını belirlemekdir. Gereç ve Yöntem: Çalışmaya Celal Bayar Üniversitesi Tıp Fakültesi Gastroenteroloji kliniğinde Haziran 2008-Haziran 2010 yılları arasında üst gastrointestinal sistem endoskopisi ve biyopsisi yapılan 1597 olgu retrospektif incelenerek dahil edilmiştir. Bulgular: Endoskopik olarak normal bulunan olguların patolojik olarak normal değerlendirilmesinde özgüllük %86.8, duyarlılık %30.8, pozitif prediktif değer %19.4 ve negatif prediktif değer %92.4, endoskopik olarak gastrit değerlendirilen olguların patolojik olarak da gastrit olarak değerlendi rilmesinde özgüllük %30.8, duyarlılık %85.3, pozitif prediktif değer %89.6 ve negatif prediktif değer %23.1, endoskopik olarak malign değerlendirilen olgularda patolojik olarak da malign değerlendirilmede özgüllük %99.1, duyarlılık %96.4, pozitif prediktif değer %84.3 ve negatif prediktif değer %99.8 olarak bulunmuştur. Helikobakter pilori %40 olguda pozitif olaraksaptanmıştır. Sonuç: Her ne kadar endoskopistlerin malinite ve gastrit olarak değerlendirdikleri olgular tanı olarak patologlar ile uyumlu olsa da yalnızca bu gruplardan değil mutlaka endoskopik olarak normal nitelendirilen olgulardan da biyopsi alınması önerilir.

Anahtar Kelimeler:

Endoskopik tanı, patolojik tanı, Helikobakter pilori

What is the consistency between the diagnoses of endoscopists and pathologists concerning gastroduodenal mucosa?

Background/aims: The aim of this study was to evaluate retrospectively the consistency of the diagnoses by endoscopists and pathologists, to determine whether the endoscopic diagnosis is adequate, and to compare the endosco- pic and pathological diagnoses of Helicobacter pylori. Materials and Met- hods: 1597 subjects who underwent an upper endoscopy and an endoscopic biopsy (antrum and corpus) were recruited retrospectively from Celal Bayar University Gastroenterology Department in Manisa, Turkey between January 2008 and January 2010. Results: The specificity was 86.8%, sensitivity 30.8%, positive predictive value 19.4%, and negative predictive value 92.4% between the endoscopically normal and pathologically normal cases. The spe- cificity was 30.8% and sensitivity 85.3%, with a positive predictive value of 89.6% and a negative predictive value of 23.1% between gastritis shown en- doscopically versus pathologically. The specificity was 99.1% and sensitivity 96.4%, with a positive predictive value of 84.3% and negative predictive va- lue of 99.8%, between malignancy shown endoscopically versus pathologi- cally. Helicobacter pylori was positive in 653 (40%) patients. Conclusions: Although the endoscopic and pathological diagnoses were compatible, espe- cially when examining malignancy and gastritis, and despite the fact that the endoscopic evaluations of the upper gastrointestinal system were deemed to be normal, a biopsy is still recommended.

Keywords:

Endoscopic diagnosis, pathological diagnosis, Helicobacter pylori,

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