RT Journal Article SR Electronic T1 Is a detailed grading of villous atrophy necessary for the diagnosis of enteropathy? JF Journal of Clinical Pathology JO J Clin Pathol FD BMJ Publishing Group Ltd and Association of Clinical Pathologists SP 1051 OP 1054 DO 10.1136/jclinpath-2016-203711 VO 69 IS 12 A1 Federico Biagi A1 Claudia Vattiato A1 Marco Burrone A1 Annalisa Schiepatti A1 Simona Agazzi A1 Gregorio Maiorano A1 Ombretta Luinetti A1 Costanza Alvisi A1 Catherine Klersy A1 Gino Roberto Corazza YR 2016 UL http://jcp.bmj.com/content/69/12/1051.abstract AB Aims The utility of the 7 level Marsh–Oberhuber classification of mucosal damage in patients with coeliac disease has recently been criticised. Analysis of duodenal biopsies with dissecting microscopy is an unsophisticated method that, however, provides useful information in cases of frank villous atrophy. In the last 15 years, we have always analysed duodenal biopsies with dissecting microscopy before sending them to the pathology department for histology. If the results of dissecting microscopy and traditional histology were comparable, we feel that would be strong evidence that grading of the histological lesion would be unnecessary if not pointless in the everyday diagnosis of enteropathies.Methods The clinical notes of all 2075 patients undergoing duodenal biopsy between September 1999 and June 2015 were retrospectively analysed. Results of duodenal mucosal evaluation with both dissecting microscopy and traditional histology were collected and statistically compared.Results The κ statistics showed a substantial agreement of the two methods (κ statistics 0.78). Sensitivity of dissecting microscopy for detection of severe villous atrophy was 85.1% (95% CI 81.2% to 88.5%) and specificity was 95% (95% CI 93.8% to 96%).Conclusions Although dissecting microscopy is an unsophisticated method that obviously cannot substitute traditional histology, our results suggest that in everyday clinical practice, the diagnosis of coeliac disease and other flat enteropathies does not require grading of villous atrophy.