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Gela histological scoring system for post‐treatment biopsies of patients with gastric MALT lymphoma is feasible and reliable in routine practice

2012; Wiley; Volume: 160; Issue: 1 Linguagem: Inglês

10.1111/bjh.12078

1365-2141

Christiane Copie‐Bergman, Andrew Wotherspoon, Carlo Capella, Teresio Motta, E Pedrinis, Stefano Pileri, Francesco Bertoni, Annarita Conconi, Emanuele Zucca, Maurilio Ponzoni, Andrés J.M. Ferreri,

Helicobacter pylori-related gastroenterology studies

Summary The I nternational E xtranodal L ymphoma S tudy G roup ( IELSG ) promoted this study to determine the inter‐observer agreement in the application of the Groupe d' E tude des L ymphomes de l' A dulte ( GELA ) histological scoring system for evaluating residual disease in post‐treatment gastric biopsies of patients with gastric M ucosa‐ A ssociated L ymphoid T issue ( MALT ) lymphoma ( GML ). Twenty‐one patients with H elicobacter pylori ‐associated GML and treated with anti‐ H . pylori therapies were considered. A total of 154 biopsy sets from follow‐up endoscopic procedures after H . pylori eradication were examined independently by seven pathologists from four E uropean countries, following histological criteria suggested by the GELA scoring system. The overall concordance rate was 83% with a kappa value of 0·64, indicating a significant agreement among the seven observers. Most non‐concordant responses clustered across the border of complete remission ( CR ) and probable minimal residual disease (p MRD ), a distinction that does not imply critical clinical impact. Accordingly, when the analysis considered CR /p MRD as a single entity, the responses showed an overall concordance rate of 89% with kappa value of 0·83, thus indicating a high degree of inter‐observer agreement. This study provides additional validation of the GELA histological grading system. This scheme can therefore be recommended in routine practice and deserves to be used in prospective clinical trials.