The severity of endoscopic gastric atrophy could help to predict Operative Link on Gastritis Assessment gastritis stage.
OBJECTIVE
The aims of the present study were to evaluate the role of moderate-to-severe endoscopic gastric atrophy (EGA) on predicting Operative Link on Gastritis Assessment (OLGA) gastritis stage, and to assess the association of high-stage OLGA gastritis with gastric neoplasia in patients with non-ulcer dyspepsia.


METHODS
A cross-sectional study was carried out on 280 dyspeptic outpatients. EGA was assessed according to the Kimura-Takemoto classification. Gastritis stage was established according to the OLGA staging system and gastric neoplasia was assessed according to the Vienna classification. The pathologists who read the specimens were kept blind to the endoscopic results.


RESULTS
The mean age of patients was 46.1 years (range 20-78 years) with a male-to-female ratio of 1:1. High-stage gastritis (e.g. stage III or IV) was confirmed in 13 (4.6%) patients. All of these patients were more than 40 years-of-age (P = 0.01), had Helicobacter pylori infection (P = 0.0006) and moderate-to-severe EGA (P < 0.001). Low-grade dysplasia was found in seven patients: 4/13 (30.7%) with high-stage gastritis versus 3/267 (1.1%) with low-stage gastritis (P < 0.001). Six of these patients had moderate-to-severe EGA (P = 0.048). The sensitivity, specificity, positive predictive value and negative predictive value of this endoscopic finding in high-stage gastritis diagnosis were 100%, 57.7%, 10.3% and 100%, respectively.


CONCLUSIONS
OLGA high-stage gastritis was associated with gastric dysplasia and was mostly diagnosed in patients with moderate-to-severe EGA. The absence of this endoscopic finding could effectively rule out the possibility of having high-stage gastritis.
Department of Endoscopy, University Medical Center at Ho Chi Minh City, Vietnam.
Duc Trong
DT
Quach
Huy Minh
HM
Le
Oanh Thuy
OT
Nguyen
Trung Sao
TS
Nguyen
Naomi
N
Uemura
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005757:Gastritis, Atrophic / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005773:Gastroscopy; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology; D009626:Terminology as Topic; D014744:Vietnam; D055815:Young Adult