Original articleClinical endoscopyThe staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis
Section snippets
Patient selection
We studied 2 groups of patients. The first group included patients with a previous diagnosis of gastric IM or dysplasia. For that purpose, we used the records between 1994 and 2009 of the histology registries of the participating hospitals (Deventer Hospital, Deventer; Rijnstate Hospital, Arnhem; Erasmus Medical Center, Rotterdam, The Netherlands) to identify patients who were eligible for inclusion. In these registries with full coverage of all histopathological specimens, all biopsy specimens
Results
Overall, 204 patients were eligible for inclusion. Contact information was missing or wrong in 28 patients, and 51 patients refused to participate in this study. In total, 125 patients with a previous diagnosis of IM or dysplasia (69 male, 56 female) with a mean (±SD) age of 61 ± 11.7 years underwent surveillance endoscopy (Table 3). Ninety-eight patients (78%) were of Dutch origin, 53 patients (42%) had a previous history of Helicobacter pylori eradication, and 41 patients (33%) had a history
Discussion
This study demonstrates that replacement of AG by IM in the staging of gastritis increases interobserver agreement considerably. In addition, the correlation with the severity of gastritis remains at least as strong. Therefore, the OLGIM may be preferred over the OLGA for the prediction of gastric cancer risk in patients with pre-malignant gastric lesions.
Endoscopic follow-up of premalignant gastric lesions should be limited to patients at high cancer risk. H pylori virulence, environmental
Acknowledgments
The permission of the American Journal of Surgical Pathology for reusing the visual analog scale of the updated Sydney classification is kindly acknowledged.
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.