Assessment of the Role of Incisura Biopsy in the Staging of Chronic Gastritis

NCT ID: NCT05744596

Last Updated: 2026-01-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-03-23

Study Completion Date

2027-03-31

Brief Summary

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This prospective multicenter study investigates the added benefit of incisura biopsy to correct identification of patients with high-risk chronic gastritis (OLGA stages III-IV). It compares a biopsy protocol with and without a single incisura biopsy in a non-inferiority design.

Detailed Description

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We will perform a prospective, multicenter, randomized controlled trial of 2 different gastric biopsy protocols. Our hypothesis is that a gastric mapping protocol not including the incisura biopsy ("I-": 2 biopsies from the antrum, 2 from the corpus) is non-inferior to the conventional 5-biopsy approach ("I+": 2 biopsies from the antrum, 2 from the corpus, 1 from the incisura). The primary endpoint of this study is to assess the sensitivity of the "I-" protocol in diagnosing high-risk precancerous chronic gastritis (OLGA/OLGIM stages III or IV) compared to the assumed gold standard of histology based on the "I+" protocol.

In designing the study, we opted for a non-inferiority paired design with high-risk chronic gastritis as a primary binary outcome and a non-inferiority margin (Δ) of 5 % (two-sided 95% CI). The non-inferiority margin was established according to clinical judgement, taking into consideration the significance of a missed diagnosis of high-risk preneoplastic condition and previous estimates of the added value offered by the added incisura biopsy. With a power of 80% and a 2-sided α-level set at 0.05, we estimate that 370 subjects are needed to show non-inferiority. Finally, we will enroll 400 subjects to compensate for eventual exclusions or protocol deviations.

Cohen's kappa will be used to rate intra and inter-observer concordance for pathologists.

An intermediary analysis for futility is scheduled after 100 patients (25%) are enrolled.

Conditions

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Chronic; Gastritis, Atrophic

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Incisura biopsy +

this arm has the incisura biopsy scored and added in the OLGA final stage

Incisura biopsy analysis

Intervention Type OTHER

a pathologist blinded to the other biopsies analyzes the biopsy from the incisura

Incisura biopsy -

this arm only has corpus and antrum biopsies scored for OLGA staging

No interventions assigned to this group

Interventions

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Incisura biopsy analysis

a pathologist blinded to the other biopsies analyzes the biopsy from the incisura

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* indication to perform upper GI endoscopy for diagnosis or surveillance

Exclusion Criteria

* lack of informed consent, previously diagnosed advanced gastric cancer, incomplete endoscopy, surgically altered stomach
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Clinical Hospital Colentina

OTHER

Sponsor Role lead

Responsible Party

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Andrei Voiosu

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Colentina Clinical Hospital

Bucharest, Bucharest, Romania

Site Status RECRUITING

Countries

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Romania

Central Contacts

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Andrei Voiosu

Role: CONTACT

+40213173245

Facility Contacts

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Andrei Voiosu, PhD

Role: primary

+4 021 3173245

Other Identifiers

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INCREASE

Identifier Type: -

Identifier Source: org_study_id

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