Johansen A, Sikjaer B
Scand J Gastroenterol. 1975;10(5):453-8.
For three years (1970-72) endoscopic gastric biopsies from 883 lesions in 862 patients were histologically examined, every single biopsy (4088) separately. In 38% of the cases, namely 142 malignant and 194 benign lesions, the diagnoses could be verified. If the criterion for a positive examination was that one of the biopsies showed unambigous carcinoma, the sensitivity of the examination was 76%, the specificity 99%, the PVpos 98%, and the PVneg 85% for the first examination, using the terms of Vecchio. If the biopsy diagnoses carcinoma with some uncertaincy and precancerous biopsies were considered positive too, and if all examinations prior to verification were included, the corresponding figures were 88%, 98%, 97%, and 91%. The most common number of biopsies used in an examination for diagnosing carcinoma was 4 (range 1-11). Fewer biopsies were used if the carcinomas were localized to the whole stomach, were protruded or had a largest diameter of more than 7 cm. The characteristic 'protruded' was the only tumour criterion which significantly was found most common among positive examinations. Ulcer-like carcinomas were common among the false negative. On the basis of pathoanatomy no special number of biopsies to be taken per examination could be recommended.
在三年时间里（1970 - 1972年），对862例患者的883处病变进行了内镜下胃活检，并对每一份活检样本（共4088份）进行了组织学检查。在38%的病例中，即142处恶性病变和194处良性病变，诊断得以证实。按照韦基奥的术语，如果阳性检查的标准是其中一份活检显示明确的癌，那么首次检查的敏感度为76%，特异度为99%，阳性预测值为98%，阴性预测值为85%。如果活检诊断癌存在一定不确定性且癌前活检也被视为阳性，并且将所有确诊前的检查都包括在内，相应的数据分别为88%、98%、97%和91%。用于诊断癌的检查中最常用的活检数量为4次（范围为1 - 11次）。如果癌局限于整个胃部、呈突出状或最大直径超过7厘米，则使用的活检次数较少。特征性的“突出状”是在阳性检查中唯一显著最常见的肿瘤标准。溃疡样癌在假阴性中较为常见。基于病理解剖学，无法推荐每次检查应取的特定活检数量。
