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CC BY 4.0 · Endosc Int Open 2025; 13: a25420880
DOI: 10.1055/a-2542-0880
Original article

Prevalence and endoscopic-histological correlation of premalignant gastric lesions at a university hospital in Uruguay

Authors

  • Ignacio Moratorio

    1   Unidad Académica Gastroenterología, Hospital de Clinicas Doctor Manuel Quintela, Montevideo, Uruguay (Ringgold ID: RIN226552)

  • Adrian Canavesi

    1   Unidad Académica Gastroenterología, Hospital de Clinicas Doctor Manuel Quintela, Montevideo, Uruguay (Ringgold ID: RIN226552)

  • Carolina Olano 

    1   Unidad Académica Gastroenterología, Hospital de Clinicas Doctor Manuel Quintela, Montevideo, Uruguay (Ringgold ID: RIN226552)

  • Klaus Mönkemüller

    1   Unidad Académica Gastroenterología, Hospital de Clinicas Doctor Manuel Quintela, Montevideo, Uruguay (Ringgold ID: RIN226552)
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Abstract

Background and study aims

Although chronic atrophic gastritis (CAG), intestinal metaplasia (IM), and dysplasia constitute gastric pre-neoplastic conditions of gastric cancer (GC), data on endoscopic correlation and the prevalence in many South American countries are scarce. The aims of this study were to establish prevalence and perform endoscopic-histological correlation of gastric pre-neoplastic conditions using high-definition white light endoscopy (WLE) and to determine interobserver agreement for endoscopic findings for CAG and IM.

Patients and methods

A prospective, observational, descriptive, cross-sectional study was carried out at a Uruguayan hospital during a 6-month period. Risk was stratified according to Operative Link for Gastritis Assessment and Operative Link for Gastric Intestinal Metaplasia stage for CAG and IM, respectively. An independent and blinded second observer was included to determine interobserver endoscopic and histologic agreement.

Results

A total of 102 patients (mean age 57 years ± 1.6 years, 68.6% woman) were included. Prevalence of histological CAG and IM were 38.2% and IM 31.4%, respectively. Endoscopic-histological correlation for CAG had kappa index 0.063, sensitivity 46%, and specificity 60%. For endoscopic IM, the kappa index was 0.216, sensitivity 22%, and specificity 96%. Interobserver variability was good for gastric fold flattening and very good in the presence of whitish-greyish plaques for CAG and IM, respectively.

Conclusions

The endoscopic-histological correlation of both CAG and IM was low, raising the need for biopsy for diagnosis in all cases, regardless of HD-WLE findings. Although prevalence of gastric pre-neoplastic conditions in this group of Uruguayan patients was comparable to those described in countries with a high incidence of GC, a low proportion of high-risk stages (III and IV) was identified.

Keywords

Endoscopy Upper GI Tract - Precancerous conditions & cancerous lesions (displasia and cancer) stomach - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE) - Quality and logistical aspects - Training


Publication History

Received: 07 May 2024

Accepted after revision: 14 February 2025

Accepted Manuscript online:
18 February 2025

Article published online:
14 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Ignacio Moratorio, Adrian Canavesi, Carolina Olano, Klaus Mönkemüller. Prevalence and endoscopic-histological correlation of premalignant gastric lesions at a university hospital in Uruguay. Endosc Int Open 2025; 13: a25420880.
DOI: 10.1055/a-2542-0880
 

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