Sauerbruch T, Schreiber M A, Schüssler P, Permanetter W
Endoscopy. 1984 May;16(3):101-4. doi: 10.1055/s-2007-1018546.
Endoscopy of the stomach was performed in 152 consecutive patients alternately by two endoscopists, such that the non-examining endoscopist always followed the procedure via a teaching attachment. A fiberscope with a close-focusing optical system for magnification of the mucosa was used. The interobserver reliability of eleven predefined macroscopic criteria was analysed and these criteria were compared with the histological diagnosis for each gastric region (body, transitional zone, antrum). The percentage of agreement between the two observers ranged between 80% and 97% for all criteria except mucosal erythema (74, 68, 62%) and mucus covering (53, 61, 87%). A consideration of all three gastric regions reveals that only one macroscopic criterion (visibility of submucosal vessels) correlated significantly with the histological diagnosis (i.e. atrophic gastritis). Other macroscopic criteria that correlated significantly with the histological diagnosis were most often observed in the gastric body. Their positive predictive value, however, rarely exceeded 50 percent. Thus, even with the use of modern instruments, endoscopy is of limited value for the prediction of gastritis identified by histology.
152例连续患者的胃镜检查由两名内镜医师交替进行，未操作的内镜医师始终通过教学附件观察检查过程。使用了具有近距离聚焦光学系统以放大黏膜的纤维内镜。分析了11项预先定义的宏观标准的观察者间可靠性，并将这些标准与每个胃区域（胃体、过渡区、胃窦）的组织学诊断进行比较。除黏膜红斑（74%、68%、62%）和黏液覆盖（53%、61%、87%）外，所有标准下两名观察者之间的一致率在80%至97%之间。综合考虑所有三个胃区域发现，只有一项宏观标准（黏膜下血管可见性）与组织学诊断（即萎缩性胃炎）显著相关。其他与组织学诊断显著相关的宏观标准最常出现在胃体。然而，它们的阳性预测值很少超过50%。因此，即使使用现代仪器，内镜检查对组织学确诊的胃炎的预测价值也有限。
