Correlation between the endoscopic and histologic diagnosis of gastritis

Our aims were to determine the rate of concordance between endoscopic and pathologic diagnoses of gastritis and to determine if there was any common factor in discordant cases. A retrospective analysis of data from 400 patients was performed. The endoscopic diagnoses were compared with the pathologic diagnoses, and histologic slides from discordant cases were reviewed. Of the 400 patients, there was discordance between endoscopy and histology in 136 (34%; κ statistic, 0.31). These discordant cases comprised 56 with normal endoscopy but abnormal histology and 80 with abnormal endoscopy but normal histology. In 13 patients, there was normal histology, although erosions had been diagnosed endoscopically. No consistent histologic features were found in the discordant cases. These findings show that standard endoscopy is a poor predictor of pathologic changes. Biopsies are required for accurate diagnosis of gastritis.