ABSTRACT
Objective To study the relationship between endoscopic and histologic mucosal changes in chronic gastritis.Methods All 403 patients with chronic gastritis were examined by endoscopy and two samples of gastric mucosa were examined by the same pathologist.Results (1)Gastroscopic results:there were 380 cases of chronic superficial gastritis(CSG),38 cases of chronic atrophic gastritis(CAG) including 15 cases of coexistence of CSG and CAG.(2)Pathologic results:365 cases of CSG;49 cases of CAG including 11 cases of coexistence of CSG and CAG.Among 403 cases,108 cases with intestinal metaplasia(IM),59 cases with mucosal erosion.39 cases had active chronic gastritis(ACG).(3)For CSG,comparing with pathology,endoscopic results had 95.3% of sensitivity and 91.6% of positive predictive value.In contrast their specific rate and negative predictive value were 15.8% and 26.6%,respectively;for CAG,endoscopy had 96.0% of specific rate and 93.2% of negative predictive value for pathologic diagnosis.Its sensitivity and positive predictive value were 46.2% and 63.2% respectively.(4)Comparing with pathologic results,endoscopic features had less sensitivity(50%),but some had a higher positive predictive value for pathologic CSG,CAG,and IM.(5)CAG was most likely associated with type Ⅱ IM(85.2%).Although most type Ⅰ IM was presented in CSG(81.0%).Conclusion Any single endoscopic finding was nonspecific for pathologic diagnosis;although some charactristical endoscopic findings had a higher positive predictive value. In other words,a single pathologic change may associated with various endoscopic findings, while a single later finding only presented one or two pathologic changes.