Korean Journal of Gastrointestinal Endoscopy 2004;28(4): 161-167.
확대내시경검사에서 위병변의 형태분류법에 따른 관찰자 간 일치도에 관한 연구
고봉민·장재영·권광안·김성환·이상호·정인섭·홍수진·유창범·조영덕·김진오·조주영·
순천향대학교 의과대학 내과학교실, 소화기연구소
Interobserver Agreement in Gastric Lesions by Magnifying Endoscopy
Bong Min Ko, M.D., Jae Young Jang, M.D., Kwang An Kwon, M.D., Seong Hawn Kim, M.D.,
Department of Internal Medicine, Institute for Digestive Research, Soon Chun Hyang
Abstract
Background/Aims: Various magnifying endoscopic classifications have been introduced in
esophageal and gastric lesions. However, studies on an agreement between observers according to
the form classification of magnifiying endoscopic findings have not been performed yet. The aim of
this study was to determine the interobserver agreement for magnifying endoscopic classifications.
Methods: The patients were divided into 3 groups. The first group of patients had post-EMR ulcer
scar (50 cases), the second group, elevated gastric lesion (38 cases), and the third group, gastritis
(43 cases). Two mucosal patterns were used in the post-EMR ulcer scar group, 6 mucosal patterns
in the elevated gastric lesion group, and 3 patterns of the collecting venule in the gastritis group.
Three experienced observers (A, B, C) blinded to the patients' data participated in this study. The
agreement between observers was evaluated by calculated kappa. The kappa value of 0.75 or
greater was rated excellent, 0.4∼0.74, fair to good, and 0.4 or less, poor. Results: Regarding 2
mucosal pattern in post- EMR ulcer scar, agreements between A and B, A and C, and B and C
were 0.896, 0.793, and 0.901, respectively (p＜0.01). Regarding 6 mucosal patterns in elevated
gastric lesion, agreements between A and B, A and C, and B and C were 0.607, 0.458, and 0.557,
respectively (p＜0.01). Regarding 3 collecting venule pattern in gastritis, agreements between A and
B, A and C, and B and C were 0.822, 0.823, and 0.751, respectively (p＜0.01). Conclusions:
Interobserver agreement is good to excellent in mucosal pattern and collecting venule by magnifying
endoscopy. However magnifying endoscopic classification needs to be refinded in order to improve
an agreement between observers. (Korean J Gastrointest Endosc 2004;28:161167)
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