Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study.
BACKGROUND
Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk.


OBJECTIVE
To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression.


METHODS
Ninety-three Italian patients were followed up for more than 12 years (range: 144-204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2).


RESULTS
All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P < 0.001). OLGA-staging at T1 predicted both the OLGA stage (Kaplan-Maier log-rank test, P = 0.001) and the neoplasia at T2 (Kaplan-Maier log-rank test, P = 0.001).


CONCLUSIONS
This long-term follow-up study provides the first evidence that gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori-status, gastritis patients could be confidently stratified and managed according to their different cancer risks.
Rugge
M
M
Department of Diagnostic Medical Sciences and Special Therapies, University of Padova, Italy. massimo.rugge@unipd.it <massimo.rugge@unipd.it>
de Boni
M
M
Pennelli
G
G
de Bona
M
M
Giacomelli
L
L
Fassan
M
M
Basso
D
D
Plebani
M
M
Graham
D Y
DY
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology*