Abstract:
OBJECTIVE:Guidelines mandate expert pathology review of Barrett's oesophagus (BO) biopsies that reveal dysplasia, but there are no evidence-based standards to corroborate expert reviewer status. We investigated BO concordance rates and pathologist features predictive of diagnostic discordance. DESIGN:Pathologists (n=51) from over 20 countries assessed 55 digitised BO biopsies from across the diagnostic spectrum, before and after viewing matched p53 labelling. Extensive demographic and clinical experience data were obtained via online questionnaire. Reference diagnoses were obtained from a review panel (n=4) of experienced Barrett's pathologists. RESULTS:We recorded over 6000 case diagnoses with matched demographic data. Of 2805 H&E diagnoses, we found excellent concordance (>70%) for non-dysplastic BO and high-grade dysplasia, and intermediate concordance for low-grade dysplasia (42%) and indefinite for dysplasia (23%). Major diagnostic errors were found in 248 diagnoses (8.8%), which reduced to 232 (8.3%) after viewing p53 labelled slides. Demographic variables correlating with diagnostic proficiency were analysed in multivariate analysis, which revealed that at least 5 years of professional experience was protective against major diagnostic error for H&E slide review (OR 0.48, 95% CI 0.31 to 0.74). Working in a non-teaching hospital was associated with increased odds of major diagnostic error (OR 1.76, 95% CI 1.15 to 2.69); however, this was neutralised when pathologists viewed p53 labelled slides. Notably, neither case volume nor self-identifying as an expert predicted diagnostic proficiency. Extrapolating our data to real-world case prevalence suggests that 92.3% of major diagnostic errors are due to overinterpreting non-dysplastic BO. CONCLUSION:Our data provide evidence-based criteria for diagnostic proficiency in Barrett's histopathology.
journal_name
Gutjournal_title
Gutauthors
van der Wel MJ,Coleman HG,Bergman JJGHM,Jansen M,Meijer SL,BOLERO working group.doi
10.1136/gutjnl-2019-318985subject
Has Abstractpub_date
2020-05-01 00:00:00pages
811-822issue
5eissn
0017-5749issn
1468-3288pii
gutjnl-2019-318985journal_volume
69pub_type
杂志文章,多中心研究相关文献
GUT文献大全abstract:OBJECTIVE:Metabolic syndrome (MetS) arises from complex interactions between host genetic and environmental factors. Although it is now widely accepted that the gut microbiota plays a crucial role in host metabolism, current knowledge on the effect of host genetics on specific gut microbes related to MetS status remain...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gutjnl-2015-311326
更新日期:2017-06-01 00:00:00
abstract::A chronic colitis has been induced in rabbits having many of the histological features of human ulcerative colitis. Animals were first immunised with the common enterobacterial antigen of Kunin and haemagglutinating antibodies demonstrated in high titre. An immune complex colitis was then established by the injection ...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.20.1.1
更新日期:1979-01-01 00:00:00
abstract::Prostaglandins (PGs) are synthesised by gastric mucosa, and have been shown to inhibit gastric acid secretion and ulcer formation in man and experimental animals. Recently exogenous PGs, mainly of the E group, have been used for the treatment of peptic ulcer disease. We therefore searched for a drug that would stimula...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.20.10.882
更新日期:1979-10-01 00:00:00
abstract::The lectin, phytohaemagglutinin, present in beans survives passage through the gastrointestinal tract in a biologically and immunologically intact form. It is known that by binding to the brush border membranes of the small intestine phytohaemagglutinin induces its hyperplastic growth. However, its effect on the other...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.37.3.353
更新日期:1995-09-01 00:00:00
abstract::It has been proposed that anti-inflammatory actions of corticosteroids rely on promotion of a natural peptide phospholipase A2 inhibitor, lipocortin, but in vivo effects on arachidonic acid metabolism have not been shown. Equilibrium dialysis of the rectum in patients with ulcerative colitis was used to determine whet...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.28.9.1095
更新日期:1987-09-01 00:00:00
abstract::A simple method based on atomic absorption spectrophotometry and using protein concentration as the reference standard was used for measuring the total tissue iron concentration in needle liver biopsy specimens from 47 patients with varying levels of body iron stores. The values obtained showed a close correlation ove...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.12.12.1011
更新日期:1971-12-01 00:00:00
abstract:BACKGROUND/AIMS:In 1998 the PPP2R1B gene encoding the A subunit of the serine/threonine protein phosphatase was identified as a putative tumour suppressor gene in lung and colon cancer in the chromosome region 11q22-24. The aim of the present study was to determine the type of alterations in primary rectal cancers as w...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.47.2.268
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Postpolypectomy surveillance guidelines for colorectal cancer introduced the concept of 'risk stratification'; however, few studies have been conducted for validation of its usefulness. The aim of this study was to assess the 5-year incidence of advanced neoplasia recurrence based on the risk stratification s...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2010.232876
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND AIMS:The incidence of oesophageal adenocarcinoma (OAC) has been increasing rapidly with a dismal survival rate of less than 20%. Understanding the genomic aberrations and biology of this cancer may enhance disease interventions. This study aimed to use genome-wide genomic and expression data to enhance t...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2010.234179
更新日期:2011-10-01 00:00:00
abstract::The experience of The Middlesex Hospital in the investigation and management of chronic intestinal arterial occlusion (IAO) over a 20 year period is presented. Of some 100 patients referred only 28 were found to have IAO and these were critically evaluated in terms of insorptive and exsorptive function. No relation wa...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.26.7.656
更新日期:1985-07-01 00:00:00
abstract::Spirits from areas of high and low incidence of cancer of the oesophagus were examined for volatile nitrosamines using a chemiluminescent detector. No nitrosamines were found, the detection limit being 0.001 microng/ml. ...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.18.4.301
更新日期:1977-04-01 00:00:00
abstract::The aim of this study is to assess the value of jejunal manometry in the diagnosis of subacute mechanical obstruction distal to the proximal small bowel. In a retrospective review of 850 manometric tracings carried out in patients with unexplained nausea, vomiting, abdominal pain or altered bowel movements, 16 tracing...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.30.4.468
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:"Probiotic" bacteria are effective in treating some inflammatory bowel diseases. However which bacteria confer benefit and mechanisms of action remain poorly defined. Dendritic cells, which are pivotal in early bacterial recognition, tolerance induction, and shaping of T cell responses, may be central in med...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2003.037325
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND AND AIM:Hepatic stellate cells (HSCs) are key participants in liver fibrosis development. 1,25(OH)(2)D(3), the active form of vitamin D, has antiproliferative properties and antifibrotic potential, as well as a role in extracellular matrix and matrix metalloproteinase (MMP) regulation in renal and lung fibro...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2010.234666
更新日期:2011-12-01 00:00:00
abstract::Six New Zealand white rabbits were given gas induction anaesthetics and maintained on glucochloralose (Merck) 60 mg/kg given intravenously. Intracolonic pressures were measured after a standard dose of prostigmine, 0.05 mg/kg, using fluid-filled, open-tipped, narrow-bore polythene tubes. Then the rabbits were put on a...
journal_title:Gut
pub_type: 杂志文章
doi:
更新日期:1972-10-01 00:00:00
abstract::The use of tripotassium dicitrato bismuthate (TDB) has been suggested recently for cimetidine resistant duodenal ulcers. This study compares the efficacy of TDB with two different cimetidine dosages in the treatment of duodenal ulcer patients who failed to respond to an eight week therapy with H2-blockers. Fifty two p...
journal_title:Gut
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/gut.28.7.907
更新日期:1987-07-01 00:00:00
abstract::Completeness of vagotomy has been assessed by use of the electrical stimulation test and the insulin test in 50 patients suffering from chronic duodenal ulceration. A positive result from either was taken as evidence of incomplete vagotomy. The electrical stimulation test provided such evidence more often than the ins...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.12.8.629
更新日期:1971-08-01 00:00:00
abstract::Human cholera is associated with an increased luminal release of prostaglandin E2 (PGE2), but whether inhibition of increased PGE2 synthesis will reduce or control intestinal secretion is uncertain. 'Steady state' perfusions (10 ml/minute) in 12 patients with acute cholera, and repeat perfusions in nine of these patie...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.33.5.643
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:Many patients with Crohn's disease (CD) have low bone mineral density (BMD) that may not be solely attributable to glucocorticoid use. We hypothesised that low BMD in patients with CD is associated with elevated circulating levels of the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)(2)D). We fu...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2003.036657
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:The major potential site of acid nitrosation is the proximal stomach, an anatomical site prone to a rising incidence of metaplasia and adenocarcinoma. Nitrite, a pre-carcinogen present in saliva, can be converted to nitrosating species and N-nitroso compounds by acidification at low gastric pH in the presenc...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2007.128587
更新日期:2007-12-01 00:00:00
abstract::For the first time the endoscopist has more than one option for the management of gastro-oesophageal varices. It is now feasible to select the appropriate therapy on the basis of the clinical setting. Acute injection sclerotherapy remains a quick and simple technique for the control of active bleeding from oesophageal...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.36.5.647
更新日期:1995-05-01 00:00:00
abstract::Both carbachol (10(-4)-10(-3) mol/l) and cholecystokinin octapeptide (CCK-8) (10(-8)-10(-6) mol/l) significantly stimulated the release of pepsinogen from rabbit gastric mucosa maintained in organ culture (213-216% and 143-261% of control, respectively, p less than 0.05-0.01). The secretion was not affected by removin...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.33.1.21
更新日期:1992-01-01 00:00:00
abstract::This paper reports the association between severe, prolonged, watery diarrhoea and islet cell tumours of the pancreas. There appear to be significant differences between patients with these symptoms and those with the classical Zollinger-Ellison syndrome. ...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2.1.12
更新日期:1961-03-01 00:00:00
abstract:BACKGROUND:Interstitial cells of Cajal (ICC) are required for normal intestinal motility. ICC are found throughout the human colon and are decreased in the sigmoid colon of patients with slow transit constipation. AIMS:The aims of this study were to determine the normal distribution of ICC within the human colon and t...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.51.4.496
更新日期:2002-10-01 00:00:00
abstract::We determined the ionic composition of faecal fluid from 13 patients with Crohn's disease limited to the colon, 10 with diffuse ulcerative colitis, and eight with ulcerative proctitis. The Crohn's and colitis groups had similar proportions of colon surface involved radiographically and similar 24 hour faecal weights. ...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.23.4.326
更新日期:1982-04-01 00:00:00
abstract::Patients with the Peutz-Jeghers syndrome carry a slight, though definite, increased risk of gastrointestinal carcinoma. The malignant potentiality of Peutz-Jeghers hamartomatous polyps, generally considered benign, is supported by this report. Two cases of metastasising gastrointestinal carcinoma associated with the P...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.20.2.169
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND/AIMS:To evaluate the response of endocrine cells of the gastric oxyntic mucosa in hypergastrinaemic patients to either antrectomy or treatment with the somatostatin analogue octreotide. PATIENTS:(a) Two patients with enterochromaffin-like (ECL) cell carcinoid and chronic atrophic gastritis, treated with ant...
journal_title:Gut
pub_type: 临床试验,杂志文章
doi:10.1136/gut.38.5.668
更新日期:1996-05-01 00:00:00
abstract::The records of 113 consecutive patients with a suspected gastrointestinal motility disorder referred between January 1988 and July 1991 were retrospectively reviewed. The aims were to identify the prevalence of autonomic dysfunction in those with or without associated neurological disease and to determine the diagnost...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.34.3.397
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND/AIM:To examine the risks for hepatocellular carcinoma (HCC) with respect to hepatitis B virus (HBV) genotypes, specific viral mutations (MT), serum HBV DNA levels, and cirrhosis. METHODS:HBV genotypes, 1653/1753/core promoter (CP)/precore MT and HBV DNA levels were determined in 248 HBV patients with HCC an...
journal_title:Gut
pub_type: 杂志文章
doi:10.1136/gut.2007.119859
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:In this consensus statement, an international panel of experts deliver their opinions on key questions regarding the contribution of the human microbiome to carcinogenesis. DESIGN:International experts in oncology and/or microbiome research were approached by personal communication to form a panel. A structu...
journal_title:Gut
pub_type: 共识发展会议,杂志文章
doi:10.1136/gutjnl-2019-318556
更新日期:2019-09-01 00:00:00