Abstract:
The extent of gastric intestinal metaplasia (GIM) can be used to determine the risk of gastric cancer. Eleven international
gastrointestinal expert pathologists estimated the extent of GIM on haematoxylin and eosin (H&E)- and Alcian blue-Periodic
acid Schiff (AB-PAS)-stained slides of 46 antrum biopsies in 5% increments. Interobserver agreement was tested with the
intraclass correlation coefficient (ICC). Correlation between standard deviation and extent of GIM was evaluated with the
Spearman correlation. The interobserver agreement was very good (ICC = 0.983, 95% confidence interval (CI) 0.975–0.990).
The use of AB-PAS did not increase the agreement (ICC = 0.975, 95% CI 0.961–0.985). Cases with a higher amount of
metaplastic epithelium demonstrated a higher standard deviation (rs = 0.644; p < 0.01), suggesting lower diagnostic accuracy
in cases with extensive GIM. In conclusion, estimating the extent of GIM on H&E-stained slides in patients with chronic
atrophic gastritis can be achieved satisfactorily with high interobserver agreement, at least among international expert gastrointestinal
pathologists.
