Biopsy sampling in upper gastrointestinal endoscopy – a survey from ten tertiary referral centres across Europe.

Jan Bornschein, Terry Tran-Nguyen, Gloria Fernandez-Esparrach, Stephen Ash, Francesc Balaguer, Elisabeth Bird-Lieberman, Henry Córdova, Zane Dzerve, Matteo Fassan, Marcis Leja, Ivan Lyutakov, Tim Middelburg, Leticia Moreira, Radislav Nakov, Stella A. V. Nieuwenburg, Anthony O'Connor, Stefano Realdon, Heiko DeSchepper, Annemieke Smet, M.C.W. SpaanderIvars Tolmanis, Tadas Urbonas, Jochen Weigt, Georgina L. Hold, Alexander Link, Juozas Kupcinskas

Research output: Contribution to journalArticlepeer-review


Background: Guidelines give robust recommendations on which biopsies should be taken when there is endoscopic suggestion of gastric inflammation. Adherence to these guidelines often seems arbitrary. This study aimed to give an overview on current practice in tertiary referral centres across Europe. Methods: Data were collected at 10 tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings, and the number and sampling site of biopsies were recorded. Findings were compared between centres, and factors influencing the decision to take biopsies were explored. Results: Biopsies were taken in 56.6% of 9,425 procedures, with significant variation between centres (p < 0.001). Gastric biopsies were taken in 43.8% of all procedures. Sampling location varied with the procedure indication (p < 0.001) without consistent pattern across the centres. Fewer biopsies were taken in centres which routinely applied the updated Sydney classification for gastritis assessment (46.0%), compared to centres where this was done only upon request (75.3%, p < 0.001). This was the same for centres stratifying patients according to the OLGA system (51.8 vs. 73.0%, p < 0.001). More biopsies were taken in centres following the MAPS guidelines on stomach surveillance (68.1 vs. 37.1%, p < 0.001). Biopsy sampling was more likely in younger patients in 8 centres (p < 0.05), but this was not true for the whole cohort (p = 0.537). The percentage of procedures with biopsies correlated directly with additional costs charged in case of biopsies (r = 0.709, p = 0.022). Conclusion: Adherence to guideline recommendations for biopsy sampling at gastroscopy was inconsistent across the participating centres. Our data suggest that centre-specific policies are applied instead.
Original languageEnglish
Number of pages11
JournalDigestive Diseases
Publication statusPublished - 1 Oct 2020
Externally publishedYes


  • Gastritis
  • Biopsy sampling
  • Gastroscopy
  • CLO test

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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