Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey from 10 Tertiary Referral Centres across Europe

Jan Bornschein (Coresponding Author), Terry Tran-Nguyen, Gloria Fernandez-Esparrach, Stephen Ash, Francesc Balaguer, Elisabeth L. 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 De Schepper, Annemieke Smet, M. C.W. SpaanderIvars Tolmanis, Tadas Urbonas, Jochen Weigt, Georgina L. Hold, Alexander Link, Juozas Kupcinskas

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
5 Downloads (Pure)


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
Pages (from-to)179-189
Number of pages11
JournalDigestive Diseases
Issue number3
Early online date1 Oct 2020
Publication statusPublished - May 2021
Externally publishedYes


  • Biopsy sampling
  • CLO test
  • Gastritis
  • Gastroscopy
  • MAPS
  • OLGA
  • Sydney

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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