{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:55:45Z","timestamp":1768899345946,"version":"3.49.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1999,8]]},"abstract":"<jats:p>AIM: To test the reproducibility between two histopathologists of features of Helicobacter pylori gastritis, using the updated Sydney classification. METHODS: 290 dyspeptic Dutch patients with biopsy proven H pylori infection were enrolled in the study. Gastric antral mucosal biopsy specimens were analysed before and after H pylori eradication treatment. The biopsies were scored semi-quantitatively by two histopathologists, according to the updated Sydney classification system. Variables analysed included the density of H pylori infection, the degree of chronic inflammation, inflammatory activity, atrophy, intestinal metaplasia, and surface epithelial damage. Before grading biopsy specimens, both pathologists reached a consensus on the scoring of gastritis through interactive sessions using a multiheaded microscope. Subsequently all biopsy specimens were graded. Interobserver variability was also analysed using weighted kappa scores. RESULTS: For interobserver agreement on scoring the various gastritis features a high degree of reproducibility was reached overall. Agreement on grading of atrophy was the lowest; however, moderate to good reproducibility was achieved, with weighted kappa values of 0.49 in the pretreatment biopsies and 0.52 in the post-treatment biopsies. Disagreement was most common in biopsy specimens with lesser degrees of atrophy. A high degree of agreement was obtained for intestinal metaplasia, with weighted kappa values of 0.72 in the pretreatment biopsies and 0.73 in the post-treatment biopsies. The best agreement was reached in the assessment of the density of H pylori both before and after H pylori eradication treatment, with excellent weighted kappa values of 0.76 and 0.95, respectively. The grade of reproducibility of inflammatory activity, superficial epithelial damage, and chronic inflammation was high, with weighted kappa values varying from 0.60 to 0.76 and 0.62 to 0.83 before and after eradication, respectively. CONCLUSIONS: Reproducibility of grading H pylori related gastritis is high using the updated Sydney system. Despite the novel criteria for scoring atrophy, there was imperfect agreement on this feature between two independent histopathologists.<\/jats:p>","DOI":"10.1136\/jcp.52.8.612","type":"journal-article","created":{"date-parts":[[2008,12,31]],"date-time":"2008-12-31T19:05:02Z","timestamp":1230750302000},"page":"612-615","source":"Crossref","is-referenced-by-count":58,"title":["Interobserver variation in the histopathological scoring of Helicobacter pylori related gastritis."],"prefix":"10.1136","volume":"52","author":[{"given":"X Y","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R W","family":"van der Hulst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"van der Ende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S D","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G N","family":"Tytgat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F J","family":"Ten Kate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0016-5085(97)70076-3","article-title":"EVect of Helicobacter pylori eradication on gastritis in relation to cagA: a prospective 1-year follow-up study","volume":"113","author":"der Hulst RWM, Van; der Ende A, Van; FW, Dekker","year":"1997","unstructured":"Van der Hulst RWM, Van der Ende A, Dekker FW, et al. EVect of Helicobacter pylori eradication on gastritis in relation to cagA: a prospective 1-year follow-up study. Gastroenterology 1997;113:25\u201330.","journal-title":"Gastroenterology"},{"key":"ref_2","first-page":"37","article-title":"Helicobacter pylori and gastric carcinogenesis","volume":"19","author":"Correa, P.","year":"1995","unstructured":"Correa P. Helicobacter pylori and gastric carcinogenesis. Am J Surg Pathol 1995;19(suppl):s37\u201343.","journal-title":"Am J Surg Pathol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/S0140-6736(95)90113-2","article-title":"Regression of primary gastric lymphoma of MALT after cure of Helicobacter pylori infection","volume":"345","author":"BayerdorVer, E.; Neubauer, A.; Rudolph, B.","year":"1995","unstructured":"BayerdorVer E, Neubauer A, Rudolph B, et al. Regression of primary gastric lymphoma of MALT after cure of Helicobacter pylori infection. Lancet 1995;345:1591\u20134.","journal-title":"Lancet"},{"key":"ref_4","first-page":"209","article-title":"The Sydney system: a new classification of gastritis","volume":"6","author":"Misiewice, J.J.; Tytgat, G.N.J.; Goodwin, C.S.","year":"1991","unstructured":"Misiewice JJ, Tytgat GNJ, Goodwin CS. The Sydney system: a new classification of gastritis. J Hepatol Gastroenterol 1991;6:209\u201322.","journal-title":"J Hepatol Gastroenterol"},{"key":"ref_5","first-page":"1039","article-title":"The Sydney system revisited: the Houston international gastritis workshop","volume":"90","author":"Genta, R.M.; Dixon, M.F.","year":"1995","unstructured":"Genta RM, Dixon MF. The Sydney system revisited: the Houston international gastritis workshop. Am J Gastroenterol 1995;90:1039\u201341.","journal-title":"Am J Gastroenterol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0016-5085(97)80012-1","article-title":"Helicobacter pylori, inflammation, mucosal damage, and apoptosis: pathogenesis and definition of gastric atrophy","volume":"113","author":"Genta, R.M.","year":"1997","unstructured":"Genta RM. Helicobacter pylori, inflammation, mucosal damage, and apoptosis: pathogenesis and definition of gastric atrophy. Gastroenterology 1997;113:s51\u20135.","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/0895-4356(94)00225-F","article-title":"EVorts to improve interobserver agreement in histopathological grading","volume":"48","author":"Vet, H.C.W.; Koudstaal, J.; Kwee, W.S.","year":"1995","unstructured":"Vet HCW, Koudstaal J, Kwee WS, et al. EVorts to improve interobserver agreement in histopathological grading. J Clin Epidemiol 1995;48:869\u201373.","journal-title":"J Clin Epidemiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1365-2559.1994.tb01349.x","article-title":"Observer variation in the assessment of chronic gastritis according to the Sydney system","volume":"25","author":"Andrew, A.; Wyatt, J.I.; Dixon, M.F.","year":"1994","unstructured":"Andrew A, Wyatt JI, Dixon MF. Observer variation in the assessment of chronic gastritis according to the Sydney system. Histopathology 1994;25:317\u201322.","journal-title":"Histopathology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0046-8177(96)90135-5","article-title":"Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis","volume":"27","author":"El-Zimaity, H.M.T.; Graham, D.Y.; Al-assi, M.T.","year":"1996","unstructured":"El-Zimaity HMT, Graham DY, Al-assi MT, et al. Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum Pathol 1996;27:35\u201341.","journal-title":"Hum Pathol"},{"key":"ref_10","series-title":"Gut","first-page":"2","article-title":"Interobserver variation in the assessment of H pylori gastritis","volume":"39","author":"Fiocca, R.; Villani, L.; Cornaggia, M.","year":"1996","unstructured":"Fiocca R, Villani L, Cornaggia M, et al. Interobserver variation in the assessment of H pylori gastritis [abstract]. Gut 1996;39(suppl 2):A104\u20135."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1097\/00000478-199610000-00001","article-title":"Classification and grading of gastritis, the updated Sydney system","volume":"20","author":"Dixon, M.F.; Genta, R.M.; Yardley, J.H.","year":"1996","unstructured":"Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis, the updated Sydney system. Am J Surg Pathol 1996;20:1161\u201381.","journal-title":"Am J Surg Pathol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000478-199600001-00004","article-title":"Recognizing atrophy: another step toward a classification of gastritis","volume":"20","author":"Genta, R.M.","year":"1996","unstructured":"Genta RM. Recognizing atrophy: another step toward a classification of gastritis. Am J Surg Pathol 1996;20(suppl 1):s23\u201330.","journal-title":"Am J Surg Pathol"},{"key":"ref_13","series-title":"Gastroenterology 1998; 114","first-page":"318","article-title":"The relation of CagA and the long-term sequelae of gastritis after successful cure of H pylori infection\u2014a long-term follow-up study","author":"van der Hulst, R.W.M.; ten Kate, F.J.W.; Rauws, E.A.J.","unstructured":"RWM van der Hulst, FJW ten Kate, EAJ Rauws, et al. The relation of CagA and the long-term sequelae of gastritis after successful cure of H pylori infection\u2014a long-term follow-up study [abstract]. Gastroenterology 1998;114: A318."}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.52.8.612","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T08:55:44Z","timestamp":1758790544000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.52.8.612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,8]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1999,8,1]]},"published-print":{"date-parts":[[1999,8]]}},"alternative-id":["10.1136\/jcp.52.8.612"],"URL":"https:\/\/doi.org\/10.1136\/jcp.52.8.612","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,8]]}}}