scholarly journals A novel method of grading gastric intestinal metaplasia based on the combination of subtype and distribution

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ning Wei ◽  
Zhiheng Zhong ◽  
Ruihua Shi

Abstract Background Studies have shown the value of subtypes and distribution of gastric intestinal metaplasia (GIM) for prediction of gastric cancer. We aim to combine GIM subtypes and distribution to form a new scoring system for GIM. Methods This was a cross-sectional study. No GIM, type I, II, and III GIM of gastric antrum and corpus scored 0–3 points respectively. Then the severity of the whole stomach was calculated in two ways: 1. The gastric antrum and corpus scores were added together, with a score ranging from 0 to 6, which named “Subtype Distribution Score of Gastric Intestinal Metaplasia (SDSGIM)”. 2. Direct classification according to a table corresponding to that of OLGIM. We compared the SDSGIM among benign lesions, dysplasia, and cancer and drew receiver operating characteristic (ROC) curve to determine the optimal cut-off value. According to the cut-off value and the classification from the table, the predictive ability of these two methods were calculated. Results 227 patients were included. For SDSGIM, benign lesion group was significantly different from dysplasia or cancer group. Area under curve of ROC curve was 0.889 ± 0.023. The optimal cut-off value was 3. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SDSGIM for malignancy were 89.5%, 78.0%, 74.6%, 91.2% and 82.8%. And those for the second classification method were 84.2%, 82.6%, 77.7%, 87.9%, and 83.3% respectively. Conclusions This study firstly combined GIM subtypes with its distribution forming a novel scoring system, which showed high prediction accuracy for malignant lesions.

2021 ◽  
Author(s):  
Hee Kyong Na ◽  
Kee Don Choi ◽  
Young Soo Park ◽  
Hwa Jung Kim ◽  
Ji Yong Ahn ◽  
...  

Abstract Background/Aims: We aimed to develop an endoscopic scoring system to evaluate atrophic and intestinal metaplasia using narrow-band imaging (NBI) and near focus mode (NFM) to compare endoscopic scores with the Operative link for gastritis assessment (OLGA) and the Operative link for gastric intestinal metaplasia assessment (OLGIM). Methods: A total of 51 patients who underwent diagnostic esophagogastroduodenoscopy were prospectively enrolled and endoscopic scoring using NBI and NFM was performed. Four areas (the lesser and greater curvatures of the antrum and the lesser and greater curvature side of the corpus) were observed and biopsies were taken. The degree of atrophy was scored from 0 to 2 according to the Kimura-Takemoto classification (0: C0-1, 1: C2-3, 2: O1-3). The degree of metaplasia was scored from 0 to 4 (0: no metaplasia, 1: presence of metaplasia at the antrum, 2: presence of metaplasia at the corpus, add score 1: presence of metaplasia for 1/2> observed field of the picture at the antrum, add score 2: 1/2 > observed field of the picture at the corpus). The endoscopic scores were compared to the OLGA and OLGIM staging. Results: The correlation coefficient for atrophy between the endoscopic and histologic scores was 0.70 (95% CI: 0.52–0.81 p <0.001) and for metaplasia, it was 0.75 (95% CI: 0.60–0.85; p <0.001). For atrophic gastritis, endoscopic score > 1 correlated with OLGA stage III and IV with a sensitivity, specificity, positive predictive value, negative predictive value, and agreement of 88%, 74%, 75%, 87%, and 80.4%, respectively, and for metaplasia, an endoscopic score > 1 correlated with high OLGIM stage III and IV with 100%, 59%, 69%, 100%, and 78.4%, respectively. Conclusions: Endoscopic scoring for gastric atrophy and metaplasia using NBI-NFM correlate well with histologic staging.


2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199049
Author(s):  
Xujuan Liu ◽  
Min Zhang ◽  
Riyu Luo ◽  
Keran Mo ◽  
Xingxiang He

Objective Diagnosis of gastric intestinal metaplasia (GIM) relies on gastroscopy and histopathologic biopsy, but their application in screening for GIM is limited. We aimed to identify serological biomarkers of GIM via screening in Guangdong, China. Methods Cross-sectional field and questionnaire data, demographic information, past medical history, and other relevant data were collected. Blood samples were collected for pepsinogen (PG)I, PGII, gastrin-17, and Helicobacter pylori antibody testing, and gastroscopy and histopathologic biopsy were performed. Single factor and logistic regression analyses were used to evaluate the correlation between these indicators and GIM, and decision tree models were used to determine the cut-off points between indicators. Results Of 443 participants enrolled, 87 (19.6%) were diagnosed with GIM. Single factor analysis showed that pepsin indicators (PGI, PGII, and PGI/PGII ratio) and the factors Mandarin as native language, urban residency, hyperlipidemia, and age were associated with GIM. Logistic regression analysis showed that PGI and age were associated with GIM. Conclusions Age is an important factor for predicting GIM progression; age >60 years increased its risk. Detection of GIM was higher in individuals with PGI levels >127.20 ng/mL, which could be used as a threshold indicating the need to perform gastroscopy and histopathologic biopsy.


2019 ◽  
Vol 6 (6) ◽  
pp. 2080
Author(s):  
R. Anupriya ◽  
C. P. Ganesh Babu ◽  
K. V. Rajan

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV–  100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.


2018 ◽  
Vol 5 (3) ◽  
pp. 796
Author(s):  
Vamsavardhan Pasumarthi ◽  
C. P. Madhu

Background: The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to ALVARADO Score, particularly when applied to Asian population. Not many studies have been conducted to compare RIPASA and ALVARADO scoring systems. Hence, author want to compare prospectively Alvarado and RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis.Methods: A prospective analysis of 116 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. ROC curve area analysis was performed to examine diagnostic accuracy of RIPASA and ALVARADO scores.Results: The sensitivity of ALVARADO score is estimated to be 52.08 for a cut off of 6. The specificity is 80%, positive predictive value is 92.59, negative predictive value is 25.81. The Diagnostic accuracy of ALVARADO scoring is found to be 56.9. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system are 75%, 65%, 91.14%, 35.14%. The diagnostic accuracy of RIPASA score is 73.28.Conclusions: The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis. When the ROC curve was observed the area under the curve is high for RIPASA scoring system.


Author(s):  
Urmila Karya ◽  
Azme Zehra ◽  
Anupam Rani

Background: Cervical carcinoma is the second most common malignancy amongst women in India. It is regarded as a public health problem and a priority in cancer control programmes by the WHO. Colposcopy has proven to be very useful in identifying and guiding the biopsy of dysplastic lesion. To minimize inter-observer variation, colposcopic scoring system has been introduced.Methods: A prospective cross- sectional study including 250 women in whom the prevalence of different grades CIN was done. Co-relation of Pap (cytology) with colposcopy scoring system viz. Reid’s and Swede scores, has been made in this study. The two screening methods were compared and their statistical association with histological findings were analyzed.Results: Per speculum examination performed in 250 sexually active women with suspicious looking cervix, belonging to 25-60 years of age, with most common presenting complaints of pain abdomen (38.8%) followed by leucorrhoea, irregular cycles and Post coital bleed. Unhealthy cervix (49.2%) and persistent discharge (28%) were the most common indications for colposcopy. An assessment of both SWEDE score and Reid score as a function of histological findings was done, while Swede score of >5 showed slightly more sensitivity (100%) for diagnosing CIN1+ lesions, Reids score of >5 was more specific (100%) with a higher positive predictive value (100%) for diagnosing  CIN 1, 2, 3 and invasive cervical carcinoma. There was a marked positive association between Reid score and SWEDE score.Conclusions: The colposcopic scoring systems and histopathology showed significant compliance. Predictive accuracy of colposcopy increased with increasing severity of disease.


Author(s):  
Quang Huy Huynh

TÓM TẮT Đặt vấn đề: Bệnh lý nhân giáp là một bệnh lý phổ biến, đặc biệt là ở phụ nữ và người lớn tuổi. Siêu âm tuyến giáp, được xem như là một phương tiện đầu tay, là phương pháp chẩn đoán hình ảnh có những khả năng vượt trội như tương đối đơn giản, rẻ tiền, không xâm lấn, có thể lặp lại nhiều lần để chẩn đoán bệnh, và có khả năng phát hiện được những tổn thương rất nhỏ. Nghiên cứu này nhằm xác định xác giá trị của siêu âm sử dụng bảng phân loại ACR-TIRADS 2017 trong chẩn đoán nhân giáp. Phương pháp: Thiết kế nghiên cứu mô tả cắt ngang, với cỡ mẫu 169 bệnh nhân được phẫu thuật nhân giáp. Trước phẫu thuật, bệnh nhân được siêu âm tuyến giáp bằng máy GE (LOGIQ S7 Pro, LOGIQ E9 …) với đầu dò linear tần số 7,5 - 12 MHz. Kết quả siêu âm bảng phân loại TI-RADS theo ACR 2017 so sánh với tiêu chuẩn vàng là kết quả giải phẫu bệnh. Kết quả: Siêu âm áp dụng bảng phân loại ACR-TIRADS 2017 trong phân biệt nhân giáp lành tính và ác tính: Độ nhạy 97,9%, độ đặc hiệu 82,6%, giá trị tiên đoán dương 95,8%, giá trị tiên đoán âm 90,5%, và độ chính xác 94,9%. Diện tích dưới đường cong ROC (AUC) của phân loại ACR-TIRADS trong chẩn đoán nhân giáp ác tính là bằng 0,953 (p < 0,001). Điểm cắt (cut - off) được chọn là TIRADS 4. Diện tích dưới đường cong ROC (AUC) của điểm số của hạt giáp theo phân loại ACR- là 0,967 (p < 0,001). Điểm cắt (cut - off) được chọn là 5 điểm. Kết luận: Siêu âm áp dụng bảng phân loại ACR-TIRADS 2017 có giá trị trong chẩn đoán phân biệt nhân giáp lành tính và ác tính với độ nhạy và độ đặc hiệu cao. ABSTRACT THE USE OF THYROIDULTRASOUND WITH ACR - TIRADS 2017 CLASSIFICATION IN THE DIAGNOSIS OF THYROID NODULES Backgrounds: Thyroid disease is very common, especially in women and the elderly. Thyroid ultrasound, as a first - line tool, is an imaging modality with outstanding capabilities such as being relatively simple, inexpensive, non - invasive, and repeatable for diagnosis of thyroid diseases, and can detect very small lesions. This study aims to determine the use of thyroid ultrasound with ACR-TIRADS 2017 classification in the diagnosis of thyroid nodules. Methods: A cross - sectional descriptive study was conducted in 169 patients undergoing thyroidectomy. All patients had been preoperatively performed thyroid ultrasound using a GE machine (LOGIQ S7 Pro, LOGIQ E9 ...) with a linear transducer frequency of 7.5 - 12 MHz. The ultrasound results using the 2017 ACR-TIRADS classification compared with pathological findings as the gold standard diagnostics. Results: Thyroid ultrasound using the 2017 ACR-TIRADS classification could distinguish benign and malignant thyroid nodules with the sensitivity of 97.9%, specificity 82.6%, positive predictive value 95.8%, negative predictive value 90.5%, and accuracy of 94.9%. The area under the ROC curve (AUC) of the ACRTIRADS classification in the diagnosis of malignant thyroid nodules was 0.953 (p < 0.001). The cut - off point was selected as TIRADS 4. The area under the ROC curve (AUC) of the ACR - classification score of the armor particles was 0.967 (p < 0.001). The cut - off point is selected as 5 points. Conclusion: Thyroid ultrasound using the 2017 ACR-TIRADS classification is valuable in the differential diagnosis of benign and malignant thyroid nodules with high sensitivity and specificity. Keywords: Ultrasound, thyroid nodules, ACR-TIRADS 2017, benign, malignant.


2021 ◽  
Vol 10 ◽  
Author(s):  
Andreas Katsimpris ◽  
Aboulmaouahib Brahim ◽  
Wolfgang Rathmann ◽  
Anette Peters ◽  
Konstantin Strauch ◽  
...  

Abstract Numerous predictive models for the risk of type 2 diabetes mellitus (T2DM) exist, but a minority of them has implemented nutrition data so far, even though the significant effect of nutrition on the pathogenesis, prevention and management of T2DM has been established. Thus, in the present study, we aimed to build a predictive model for the risk of T2DM that incorporates nutrition data and calculates its predictive performance. We analysed cross-sectional data from 1591 individuals from the population-based Cooperative Health Research in the Region of Augsburg (KORA) FF4 study (2013–14) and used a bootstrap enhanced elastic net penalised multivariate regression method in order to build our predictive model and select among 193 food intake variables. After selecting the significant predictor variables, we built a logistic regression model with these variables as predictors and T2DM status as the outcome. The values of area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of our predictive model were calculated. Eleven out of the 193 food intake variables were selected for inclusion in our model, which yielded a value of area under the ROC curve of 0⋅79 and a maximum PPV, NPV and accuracy of 0⋅37, 0⋅98 and 0⋅91, respectively. The present results suggest that nutrition data should be implemented in predictive models to predict the risk of T2DM, since they improve their performance and they are easy to assess.


2021 ◽  
Vol 10 (15) ◽  
pp. 3448
Author(s):  
Tatsunori Hanai ◽  
Atsushi Hiraoka ◽  
Makoto Shiraki ◽  
Ryosuke Sugimoto ◽  
Nobuhito Taniki ◽  
...  

Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of “Strength” (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03–3.80) and “Falls” (OR, 2.44; 95% CI, 1.48–4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.


2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Randeep Singh ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Nani Harlina Muhammad Latar

INTRODUCTION: This study aims to evaluate the diagnostic reliability of the American College of Radiology Thyroid Imaging Report and Data System (ACR-TIRADS) and Total Malignancy Score (TMS) scoring system, in differentiating benign and malignant thyroid nodules. MATERIALS AND METHODS: This is a cross-sectional study involving patients with thyroid nodules treated at Hospital Canselor Tuanku Muhriz from October 2017 until October 2019. Ultrasound findings were scored according to the ACR[1]TIRADS and TMS scoring system. They were then correlated with the FNAC or histopathology report. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of both scoring system were calculated for analysis. RESULTS: A total of 150 patients with 223 thyroid nodules were included. 17% or 38 nodules were found to be malignant. The sensitivity, specificity, PPV, NPV and accuracy of ACR-TIRADS and TMS were 97.37% vs. 84.21 % , 52.97% vs. 62.70%, 29.84% vs. 31.68%, 98.99% vs. 95.08% and 61% vs. 66% respectively. According to the ACR-TIRADS, only hypoechoic nodules was a strong predictor of malignancy. Comparatively, in the TMS, strong predictors of malignancy include single nodule, hypoechogenicity, irregular margin, and nodules with peri and intranodular vascularity. CONCLUSION: Both ACR-TIRADS and TMS score had good diagnostic accuracy in predicting malignant thyroid nodule. TMS is comparable and not inferior to ACR[1]TIRADS however, the latter is more practical for use as growth and Doppler characteristic are not included in the assessment.


Sign in / Sign up

Export Citation Format

Share Document