Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment  

作　　者：Massimo Rugge Matteo Fassan Marco Pizzi Fabio Farinati Giacomo Carlo Sturniolo Mario Plebani David Y Graham 

机构地区：[1]Surgical Pathology and Cytopathology Unit,Department of Diagnostic Medical Sciences and Special Therapies,University of Padova [2]Istituto Oncologico del Veneto IOV-IRCCS [3]Department of Gastroenterology and Surgical Sciences,Gastroenterology Unit,University of Padova [4]Department of Diagnostic Medical Sciences and Special Therapies,Clinical Chemistry Unit,University of Padova [5]Digestive Disease Division,Baylor College of Medicine,Veterans Administration Hospital

出　　处：《World Journal of Gastroenterology》2011年第41期4596-4601,共6页世界胃肠病学杂志（英文版）

基　　金：Supported by An AIRC grant from the Veneto Regional Authorities,2009;the"Guido Berlucchi"Foundation;the"Morgagni"Association for Oncological Research (Padova;PD)

摘　　要：AIM:To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS:Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer(GC)most frequently develops.The operative link for gas-tritis assessment(OLGA)staging system ranks the GC risk according to both the topography and the severity of gastric atrophy(as assessed histologically on the ba-sis 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 re-trieved 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 OL-GIM 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 informa-tion 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 histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA staging in the identif ication of patients at high risk of gastric cancer.AIM：To compare the reliability of gastritis staging sys-tems in ranking gastritis-associated cancer risk in a large series of consecutive patients.METHODS：Gastric mucosal atrophy is the precancer-ous condition in which intestinal-type gastric cancer（GC）most frequently develops.The operative link for gas-tritis assessment（OLGA）staging system ranks the GC risk according to both the topography and the severity of gastric atrophy（as assessed histologically on the ba-sis 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 re-trieved 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 OL-GIM 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 informa-tion 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 histol-ogy report.Since it focuses on IM alone,OLGIM staging is less sensitive than OLGA stag

关 键 词：GASTRITIS STAGING Atrophic gastritis Intestinal metaplasia Operative link for gastritis assessment Operative link on intestinal metaplasia assessment 

分 类 号：R656.6[医药卫生—外科学]