Gastritis staging in clinical practice: the OLGA staging system.
BACKGROUND
The available classifications of gastritis are inconsistently used, possibly because none provides immediate prognostic/therapeutic information to clinicians. As histology reporting of hepatitis in terms of stage is clinically useful and widely accepted, an international group (Operative Link on Gastritis Assessment (OLGA)) proposed an equivalent staging system for reporting gastric histology. Gastritis staging integrates the atrophy score (obtained by biopsy) and the atrophy topography (achieved through directed biopsy mapping).


OBJECTIVE
To test in a prospective cross-sectional study whether OLGA staging consistently stratified patients according to their cancer risk and provided clear prognostic/therapeutic information.


METHODS
OLGA staging for gastric cancer risk (0-IV) and gastritis grading (overall score of the inflammatory infiltrate, grade 1-4) were applied in 439 prospectively enrolled, consecutive, dyspeptic outpatients who underwent endoscopy with standardised biopsy sampling. Incidental neoplastic lesions and coexisting peptic ulcers were recorded. Results were presented as stage (including antral (A) and corpus (C) atrophy scores) and H pylori status (eg, A = 3; C = 2: stage IV; Hp+ve).


RESULTS
Benign conditions (including duodenal ulcers; p<0.001) consistently clustered in stages 0-II, whereas all neoplastic (invasive and non-invasive) lesions clustered in stages III-IV (p<0.001).


CONCLUSIONS
Gastritis staging, combined with H pylori status, provided clinically relevant information on the overall status of the gastric mucosa with implications for prognosis, therapy and management.
Rugge
Massimo
M
Anatomia Patologica, Università degli Studi di Padova, Istituto Oncologico del Veneto IOV-IRCCS, Via Aristide Gabelli, 61, 35121 Padova, Italia. massimo.rugge@unipd.it
Meggio
Alberto
A
Pennelli
Gianmaria
G
Piscioli
Francesco
F
Giacomelli
Luciano
L
De Pretis
Giovanni
G
Graham
David Y
DY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D005756:Gastritis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000209:etiology / Q000473:pathology