AIM: To compare the reliability of gastritis staging systems in ranking gastritis-associated cancer risk in a large series of consecutive patients. METHODS: Gastric mucosal atrophy is the precancerous condition in which intestinal-type gastric cancer (GC) most frequently develops. The operative link for gastritis assessment (OLGA) staging system ranks the GC risk according to both the topography and the severity of gastric atrophy (as assessed histologically on the basis of the Sydney protocol for gastric mucosal biopsy). Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages III-IV with a higher risk of GC. A recently-proposed modification of the OLGA staging system (OLGIM) basically incorporates the OLGA frame, but replaces the atrophy score with an assessment of intestinal metaplasia (IM) alone. A series of 4552 consecutive biopsy sets (2007-2009) was retrieved and reassessed according to both the OLGA and the OLGIM staging systems. A set of at least 5 biopsy samples was available for all the cases considered. RESULTS: In 4460 of 4552 cases (98.0%), both the high-risk stages (III + IV) and the low-risk stages (0 +I + II) were assessed applying the OLGA and OLGIM criteria. Among the 243 OLGA high-risk stages, 14 (5.8%) were down-staged to a low risk using OLGIM. The 67 (1.5%) incidentally-found neoplastic lesions (intraepithelial or invasive) were consistently associated with high-risk stages, as assessed by both OLGA and OLGIM (P < 0.001 for both). Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage (stage III) were associated with a low-risk OLGIM stage (stage II). CONCLUSION: Gastritis staging systems (both OLGA and OLGIM) convey prognostically important information on the gastritis-associated cancer risk. Because of its clinical impact, the stage of gastritis should be included as a conclusive message in the gastritis histology report. Since it focuses on IM alone, OLGIM staging is less sensitive than OLGA staging in the identification of patients at high risk of gastric cancer.
AIM: To compare the reliability of gastritis staging systems in ranking gastritis-associated cancer risk in a large series of consecutive patients. METHODS:Gastric mucosalatrophy is the precancerous condition in which intestinal-type gastric cancer (GC) most frequently develops. The operative link for gastritis assessment (OLGA) staging system ranks the GC risk according to both the topography and the severity of gastric atrophy (as assessed histologically on the basis of the Sydney protocol for gastric mucosal biopsy). Both cross-sectional and long-term follow-up trials have consistently associated OLGA stages III-IV with a higher risk of GC. A recently-proposed modification of the OLGA staging system (OLGIM) basically incorporates the OLGA frame, but replaces the atrophy score with an assessment of intestinal metaplasia (IM) alone. A series of 4552 consecutive biopsy sets (2007-2009) was retrieved and reassessed according to both the OLGA and the OLGIM staging systems. A set of at least 5 biopsy samples was available for all the cases considered. RESULTS: In 4460 of 4552 cases (98.0%), both the high-risk stages (III + IV) and the low-risk stages (0 +I + II) were assessed applying the OLGA and OLGIM criteria. Among the 243 OLGA high-risk stages, 14 (5.8%) were down-staged to a low risk using OLGIM. The 67 (1.5%) incidentally-found neoplastic lesions (intraepithelial or invasive) were consistently associated with high-risk stages, as assessed by both OLGA and OLGIM (P < 0.001 for both). Two of 34 intestinal-type GCs coexisting with a high-risk OLGA stage (stage III) were associated with a low-risk OLGIM stage (stage II). CONCLUSION:Gastritis staging systems (both OLGA and OLGIM) convey prognostically important information on the gastritis-associated cancer risk. Because of its clinical impact, the stage of gastritis should be included as a conclusive message in the gastritis histology report. Since it focuses on IM alone, OLGIM staging is less sensitive than OLGA staging in the identification of patients at high risk of gastric cancer.
Entities:
Keywords:
Atrophic gastritis; Gastritis; Intestinal metaplasia; Operative link for gastritis assessment; Operative link on intestinal metaplasia assessment; Staging
Authors: C M den Hoed; B C van Eijck; L G Capelle; H van Dekken; K Biermann; P D Siersema; E J Kuipers Journal: Eur J Cancer Date: 2011-01-14 Impact factor: 9.162
Authors: N Uemura; S Okamoto; S Yamamoto; N Matsumura; S Yamaguchi; M Yamakido; K Taniyama; N Sasaki; R J Schlemper Journal: N Engl J Med Date: 2001-09-13 Impact factor: 91.245
Authors: Ki Taek Nam; Hyuk-Joon Lee; Josane F Sousa; Victoria G Weis; Ryan L O'Neal; Paul E Finke; Judith Romero-Gallo; Guanglu Shi; Jason C Mills; Richard M Peek; Stephen F Konieczny; James R Goldenring Journal: Gastroenterology Date: 2010-09-18 Impact factor: 22.682
Authors: M Rugge; P Correa; M F Dixon; R Fiocca; T Hattori; J Lechago; G Leandro; A B Price; P Sipponen; E Solcia; H Watanabe; R M Genta Journal: Aliment Pharmacol Ther Date: 2002-07 Impact factor: 8.171
Authors: Wen-Qing Li; Jun-Ling Ma; Lian Zhang; Linda M Brown; Ji-You Li; Lin Shen; Kai-Feng Pan; Wei-Dong Liu; Yuanreng Hu; Zhong-Xiang Han; Susan Crystal-Mansour; David Pee; William J Blot; Joseph F Fraumeni; Wei-Cheng You; Mitchell H Gail Journal: J Natl Cancer Inst Date: 2014-06-12 Impact factor: 13.506
Authors: Matthew Banks; David Graham; Marnix Jansen; Takuji Gotoda; Sergio Coda; Massimiliano di Pietro; Noriya Uedo; Pradeep Bhandari; D Mark Pritchard; Ernst J Kuipers; Manuel Rodriguez-Justo; Marco R Novelli; Krish Ragunath; Neil Shepherd; Mario Dinis-Ribeiro Journal: Gut Date: 2019-07-05 Impact factor: 23.059