CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(12): E1268-E1277
DOI: 10.1055/s-0043-119791
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Low yield for non-targeted biopsies of the stomach and esophagus during elective esophagogastroduodenoscopy

Michael K. Dougherty1, Phillip P. Santoiemma2, Andrew T. Weber3, David C. Metz4, Yu-Xiao Yang5
  • 1Division of Gastroenterology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
  • 2Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • 3Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
  • 4Division of Gastroenterology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • 5Division of Gastroenterology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
Further Information

Publication History

submitted 21 November 2016

accepted after revision 31 July 2017

Publication Date:
06 December 2017 (online)

Abstract

Background and study aims Biopsies of non-specific mucosal findings are often performed during esophagogastroduodenoscopy (EGD). We sought to determine the prevalence and clinical utility of non-targeted biopsies of the stomach and esophagus.

Patients and methods We conducted a retrospective review of 949 outpatient EGDs performed at a US tertiary referral center. Non-targeted biopsies of the stomach were defined as either “normal” or “mild” to “moderate” “erythema” or “inflammation” without other endoscopic features. Non-targeted biopsies of the esophagus and gastroesophageal junction (GEJ) were defined as endoscopically “normal” mucosa. The primary outcome was the proportion of non-targeted biopsies resulting in “definite management change.” Secondary outcomes included histopathologic diagnoses of Helicobacter pylori, intestinal metaplasia and esophageal eosinophilia.

Results Of 949 EGDs, 332 (35.0 %, 95 % CI 31.9 – 38.1 %) had a non-targeted biopsy taken at any site. Erythema in the gastric body and antrum was biopsied at a rate of 83 – 86 %, while biopsies of “normal”-appearing mucosa occurred at rates from 3 % (GEJ) to 15 % (body and antrum). The percentage of non-targeted biopsies that led to definite management change ranged from 5 % in the GEJ and esophagus to 9 % in the antrum, but did not significantly differ by mucosal appearance. Multivariable regression analyses suggested associations of language and age > 50 with management change from non-targeted gastric biopsy.

Conclusions Non-targeted biopsies of the stomach and esophagus led to definite management change in a small proportion of patients. Further studies are needed to identify patient and/or endoscopic characteristics and techniques to improve the yield of this practice.