title: Operative link on gastritis assessment stage is an appropriate predictor of early gastric cancer.
abstract: OBJECTIVE
  To assess the predictive value of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) stages in gastric cancer.
  
  
  METHODS
  A prospective study was conducted with 71 patients with early gastric cancer (EGC) and 156 patients with non-EGC. All patients underwent endoscopic examination and systematic biopsy. Outcome measures were assessed and compared, including the Japanese endoscopic gastric atrophy (EGA) classification method and the modified OLGA method as well as the modified OLGIM method. Helicobacter pylori (H. pylori) status was determined for all study participants. Stepwise logistic regression modeling was performed to analyze correlations between EGC and the EGA, OLGA and OLGIM methods.
  
  
  RESULTS
  For patients with EGC and patients with non-EGC, the proportions of moderate-to-severe EGA cases were 64.8% and 44.9%, respectively (P = 0.005), the proportions of OLGA stages III-IV cases were 52.1% and 22.4%, respectively (P < 0.001), and the proportions of OLGIM stages III-IV cases were 42.3% and 19.9%, respectively (P < 0.001). OLGA stage and OLGIM stage were significantly related to EGA classification; specifically, logistic regression modeling showed significant correlations between EGC and moderate-to-severe EGA (OR = 1.95, 95% CI: 1.06-3.58, P = 0.031) and OLGA stages III-IV (OR = 3.14, 95%CI: 1.71-5.81, P < 0.001), but no significant correlation between EGC and OLGIM stages III-IV (P = 0.781). H. pylori infection rate was significantly higher in patients with moderate-to-severe EGA (75.0% vs 54.1%, P = 0.001) or OLGA/OLGIM stages III-IV (OLGA: 83.6% vs 55.8%, P < 0.001; OLGIM: 83.6% vs 57.8%, P < 0.001).
  
  
  CONCLUSIONS
  OLGA classification is optimal for EGC screening. A surveillance program including OLGA stage and H. pylori infection status may facilitate early detection of gastric cancer.
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Li
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Chen
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Zhi-Zheng
authors.initials: ZZ
authors.lastname: Ge
authors.affiliation: Ying Zhou, Hai-Yan Li, Jing-Jing Zhang, Xiao-Yu Chen, Zhi-Zheng Ge, Xiao-Bo Li, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002681:China; D055088:Early Detection of Cancer; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology / Q000473:pathology
keywords: Early gastric cancer; Endoscopic gastric atrophy classification; Endoscopy; Operative Link on Gastritis Assessment/Operative Link on Gastric Intestinal Metaplasia Assessment stage; Screening