Reliability in endoscopic diagnosis of portal hypertensive gastropathy

Table 1 Group with portal hypertension and esophageal varices n (%)

Character	n = 50
Mean age (52.7 yr)
Sex
Male	28 (56)
Female	22 (44)
Etiology
Alcohol	10 (20)
Schistosomiasis	18 (36)
Hepatitis B	2 (4)
Hepatitis C	5 (10)
Alcohol and schistosomiasis	1 (2)
Alcohol, schistosomiasis and Hepatitis B	1 (2)
Autoimmune hepatitis	1 (2)
Portal vein thrombosis	1 (2)
Non-alcoholic hepatic steatosis	1 (2)
Budd-Chiari Syndrome	1 (2)
Biliary cirrhosis	1 (2)
Idiopathic or not yet identified	8 (16)
Child-pugh classification
A	42 (84)
B	6 (12)
C	2 (4)
Previous digestive bleeding	32 (64)
Previous endoscopic treatment	33 (66)
Using propanolol	25 (50)

Table 2 Analysis of the criteria from the McCormack classification for the presence of portal hypertension and portal hypertensive gastropathy

	Fine pink speckling		Superficial reddening		Mosaic-like pattern		Cherry-red spots		Diffuse hemorrhagic lesion
Diagnosis	PH	PHG	PH	PHG	PH	PHG	PH	PHG	PH	PHG
Sensitivity	48.00%	56.52%	64.00%	69.57%	48.00%	100.00%	22.00%	39.13%	8.00%	17.39%
Specificity	86.00%	76.62%	80.00%	66.23%	90.00%	92.21%	98.00%	96.10%	100.00%	100.00%
PPV	77.42%	41.94%	76.19%	38.10%	82.76%	79.31%	91.67%	75.00%	100.00%	100.00%
NPV	62.32%	85.51%	68.97%	87.93%	63.38%	100.00%	55.68%	84.09%	52.08%	80.21%
Accuracy	67.00%	72.00%	72.00%	67.00%	69.00%	94.00%	60.00%	83.00%	54.00%	81.00%
False negative	26.00%	10.00%	18.00%	7.00%	26.00%	0.00%	39.00%	14.00%	46.00%	19.00%
False positive	7.00%	18.00%	10.00%	26.00%	5.00%	6.00%	1.00%	3.00%	0.00%	0.00%
Significance	P < 0.001	P =0.03	P < 0.001	P = 0.002	P < 0.001	P < 0.001	P = 0.002	P < 0.001	P = 0.059	P = 0.002
Reliability (α)	0.4301	0.4301	0.5321	0.5321	0.7992	0.7992	0.7532	0.7532	0.5741	0.5741

¹Unsatisfactory;

²High. PPV: Positive predictive value; NPV: Negative predictive value; PH: Portal hypertension; PHG: Portal hypertensive gastropathy.

Table 3 Analysis of the criteria from the New Italian Endoscopy Club classification for the presence of portal hypertension and portal hypertensive gastropathy

	Pink		Red center		Red		Red-point		Cherry-red		Black-brown
	mosaic-like pattern		mosaic-like pattern		mosaic-like pattern		lesions		spots		spots
Diagnosis	PH	PHG	PH	PHG	PH	PHG	PH	PHG	PH	PHG	PH	PHG
Sensitivity	26.00%	52.17%	16.00%	34.78%	6.00%	13.04%	28.00%	47.83%	22.00%	39.13%	2.00%	4.35%
Specificity	90.00%	92.21%	100.00%	100.00%	100.00%	100.00%	92.00%	90.91%	98.00%	96.10%	98.00%	98.70%
PPV	72.22%	66.67%	100.00%	100.00%	100.00%	100.00%	77.78%	61.11%	91.67%	75.00%	50.00%	50.00%
NPV	54.88%	86.59%	54.35%	83.70%	51.55%	79.38%	56.10%	85.37%	55.68%	84.09%	50.00%	77.55%
Accuracy	58.00%	83.00%	58.00%	85.00%	53.00%	80.00%	60.00%	81.00%	60.00%	83.00%	50.00%	77.00%
False negative	37.00%	11.00%	42.00%	15.00%	47.00%	20.00%	36.00%	12.00%	39.00%	14.00%	49.00%	22.00%
False positive	5.00%	6.00%	0.00%	0.00%	0.00%	0.00%	4.00%	7.00%	1.00%	3.00%	1.00%	1.00%
Significance	P = 0.033	P < 0.001	P = 0.003	P < 0.001	P = 0.121	P = 0.011	P = 0.009	P < 0.001	P = 0.002	P < 0.001	P = 0.753	P = 0.358
Reliability (α)	0.5691	0.5691	0.7272	0.7272	0.0792	0.0792	0.7522	0.7522	0.7532	0.7532	0.4081	0.4081

¹Unsatisfactory;

²High. PPV: Positive predictive value; NPV: Negative predictive value; PH: Portal hypertension; PHG: Portal hypertensive gastropathy.

Table 4 Analysis of the criteria from the Baveno classification for the presence of portal hypertension and portal hypertensive gastropathy

	Pink mosaic-like pattern		Red mosaic-like pattern		Isolated red marks		Confluent red marks		GAVE
Diagnosis	PH	PHG	PH	PHG	PH	PHG	PH	PHG	PH	PHG
Sensitivity	26.00%	52.17%	6.00%	13.04%	30.00%	43.48%	10.00%	21.74%	8.00%	4.35%
Specificity	90.00%	92.21%	100.00%	100.00%	92.00%	88.31%	100.00%	100.00%	100.00%	96.10%
PPV	72.22%	66.67%	100.00%	100.00%	78.95%	52.63%	100.00%	100.00%	100.00%	25.00%
NPV	54.88%	86.59%	51.55%	79.38%	56.79%	83.95%	52.63%	81.05%	52.08%	77.08%
Accuracy	58.00%	83.00%	53.00%	80.00%	61.00%	78.00%	55.00%	82.00%	54.00%	75.00%
False negative	37.00%	11.00%	47.00%	20.00%	35.00%	13.00%	45.00%	18.00%	46.00%	22.00%
False positive	5.00%	6.00%	0.00%	0.00%	4.00%	9.00%	0.00%	0.00%	0.00%	3.00%
Significance	P = 0.033	P < 0.001	P = 0.121	P = 0.011	P = 0.005	P = 0.0014	P = 0.028	P < 0.001	P = 0.059	P = 0.429
Reliability (α)	0.5691	0.5691	0.0791	0.0791	0.7532	0.7532	0.5581	0.5581	0.5141	0.5141

¹Unsatisfactory;

²High. PPV: Positive predictive value; NPV: Negative predictive value; PH: Portal hypertension; PHG: Portal hypertensive gastropathy.

Table 5 Analysis of antral erosive gastritis in the presence of portal hypertension and portal hypertensive gastropathy

	Antral erosive gastritis		Antral elevated erosive gastritis		Antral flat erosive gastritis
Diagnosis	PH	PHG	PH	PHG	PH	PHG
Sensitivity	34.00%	39.13%	26.00%	34.78%	8.00%	4.35%
Specificity	84.00%	79.22%	92.00%	88.31%	92.00%	90.91%
PPV	68.00%	36.00%	76.47%	47.06%	50.00%	12.50%
NPV	56.00%	81.33%	55.42%	81.93%	50.00%	76.09%
Accuracy	59.00%	70.00%	59.00%	76.00%	50.00%	71.00%
False negative	33.00%	14.00%	37.00%	15.00%	46.00%	22.00%
False positive	8.00%	16.00%	4.00%	9.00%	4.00%	7.00%
Significance	P = 0.032	P = 0.046	P = 0.016	P = 0.012	P = 0.643	P = 0.297
Reliability (α)	0.8402	0.8402	0.8622	0.8622	0.6411	0.6411

¹Satisfactory;

²High. PPV: Positive predictive value; NPV: Negative predictive value; PH: Portal hypertension; PHG: Portal hypertensive gastropathy.