Impact of the angulus biopsy for the detection of gastric @entity1613 and XXXX risk assessment.

@entity1 @entity4726 @entity5 @entity194 @entity3621 @entity1613 @entity356
BACKGROUND: @entity356 and intestinal metaplasia (IM) are @entity1613 in the development of @entity356 . Histopathological assessment is based on the updated Sydney system and superordinate staging systems, operative link on @entity3621 assessment (OLGA) and operative link on @entity3621 assessment using IM (OLGIM), all requiring a biopsy from the incisura angularis (angulus). AIM: To determine the value of the angulus biopsy for the detection of @entity1613 and @entity5 risk evaluation using OLGA and OLGIM prospectively. METHODS: Biopsies from antrum (2), angulus (1) and corpus (2) were obtained from 213 @entity1 (age 19-94   years, median 54   years, female to male ratio 138:75) undergoing upper endoscopy. Histological assessment according to the updated Sydney system, OLGA and OLGIM staging was performed by gastrointestinal pathologists. Statistical analysis used exact confidence limits for dichotomous variables and repeated measurement analysis of variance. RESULTS: 8% of the cases with @entity4726 and 3% with IM (17 vs 6/213) would have been missed without the angulus biopsy. More @entity1 were diagnosed with a @entity1613 when the angulus biopsy was considered (13.1%, CI 8.9% to 18.4%), but the grade of @entity194 , if present at both sides, did not vary significantly in angulus and antrum. OLGA and OLGIM scores dropped significantly when recalculated without the angulus (difference in means  SD 0.131  0.402 and 0.075  0.313, respectively). The impact on the identification of high-risk stages is limited. CONCLUSIONS: The angulus biopsy adds to the detection of mild @entity356 in particular. It allows identifying a small additional number of @entity1 with high-risk @entity3621 .
