title: First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia.
abstract: BACKGROUND
  First-degree relatives (FDRs) of early-onset gastric carcinoma (EOGC) patients are at increased risk of cancer development. OLGA/OLGIM (Operative Link on Gastritis/Intestinal Metaplasia Assessment) classifications have been proposed for the identification of individuals at high risk of gastric cancer development.
  
  
  OBJECTIVE
  To estimate the prevalence and severity of premalignant conditions and lesions in FDRs of EOGC patients.
  
  
  METHODS
  A case-control study was conducted encompassing 103 FDRs of EOGC patients (cases) and 101 age- and gender-matched controls, all submitted to upper GI endoscopy and OLGA and OLGIM used for staging as well as modified versions with exclusion of the biopsies from incisura angularis in the analysis.
  
  
  RESULTS
  Helicobacter pylori infection was present in 82% of cases (P = 0.001). Atrophy was present in 70% of cases (OLGA stages I-IV). High-risk stages (III-IV) were identified only in cases (19%) (P < 0.001). Dysplasia was diagnosed only in cases (n = 7, P = 0.007). The application of OLGIM, modified OLGA and modified OLGIM classifications led to downgrade of stages in comparison with the original OLGA classification (27%, 15% and 30% respectively). In all classification systems, dysplastic lesions clustered (86%) in high-risk stages.
  
  
  CONCLUSIONS
  FDRs of EOGC patients have, even at young ages, a high prevalence of H. pylori infection, high-risk OLGA and OLGIM stages and dysplasia. These patients should undergo accurate endoscopic observation with at least four biopsies in antrum and corpus to allow adequate staging and follow-up of premalignant conditions and lesions scored in high-risk stages, in accordance with international guidelines recently proposed.
authors.affiliation: Institute of Biomedical Sciences, University of Porto, Portugal. ricardomarcospinto@sapo.pt
authors.forename: R
authors.initials: R
authors.lastname: Marcos-Pinto
authors.forename: F
authors.initials: F
authors.lastname: Carneiro
authors.forename: M
authors.initials: M
authors.lastname: Dinis-Ribeiro
authors.forename: X
authors.initials: X
authors.lastname: Wen
authors.forename: C
authors.initials: C
authors.lastname: Lopes
authors.forename: C
authors.initials: C
authors.lastname: Figueiredo
authors.forename: J C
authors.initials: JC
authors.lastname: Machado
authors.forename: R M
authors.initials: RM
authors.lastname: Ferreira
authors.forename: C A
authors.initials: CA
authors.lastname: Reis
authors.forename: J
authors.initials: J
authors.lastname: Ferreira
authors.forename: I
authors.initials: I
authors.lastname: Pedroto
authors.forename: J
authors.initials: J
authors.lastname: Areias
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005756:Gastritis / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000473:pathology; D010375:Pedigree; D011230:Precancerous Conditions / Q000139:chemically induced / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000473:pathology*; D013997:Time Factors