Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy

Matteo Fassan, Marco Pizzi, Fabio Farinati, Donato Nitti, Vittorina Zagonel, Robert M. Genta, Massimo Rugge

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Gastric intraepithelial neoplasia (IEN; formerly dysplasia) is an advanced precancerous lesion. Lesions indefinite for IEN mimic the IEN phenotype but lack some morphologic attributes of IEN. Indefinite for IEN lesions may arise in native foveolae (atypical foveolar hyperproliferation [aFH]) or intestinalized glands (hyperproliferative intestinal metaplasia [HIM]). The clinicopathologic outcome of such lesions is debated. We retrospectively studied the clinicopathologic behavior of 129 consecutive indefinite for IEN lesions (HIM, 98; aFH, 31; median follow-up, 31 months) and correlated outcome with the extent and topography of mucosal atrophy (assessed by OLGA staging) at the initial endoscopy/biopsy. At enrollment, aFH never coexisted with severe/extensive atrophy (all cases were in low-risk OLGA stages [0-II]), whereas HIM was associated with low- and high-risk OLGA stages (0-II, 73; III-IV, 25). At follow-up, IEN was never documented among cases enrolled as aFH, while follow-up endoscopy/biopsy documented 6 neoplastic intraepithelial lesions among 98 cases of HIM (6%, all had high-risk OLGA stages at initial biopsy). OLGA staging can stratify indefinite for IEN lesions into different risk classes, potentially contributing to decisions for a patient-specific follow-up strategy.

Original languageEnglish (US)
Pages (from-to)727-732
Number of pages6
JournalAmerican Journal of Clinical Pathology
Volume137
Issue number5
DOIs
StatePublished - May 2012

Fingerprint

Atrophy
Metaplasia
Stomach
Neoplasms
Biopsy
Endoscopy
Intestinal Mucosa
Phenotype

Keywords

  • Gastritis
  • Indefinite for intraepithelial neoplasia/dysplasia
  • OLGA staging
  • Preneoplastic lesions
  • Screening

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Fassan, M., Pizzi, M., Farinati, F., Nitti, D., Zagonel, V., Genta, R. M., & Rugge, M. (2012). Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy. American Journal of Clinical Pathology, 137(5), 727-732. https://doi.org/10.1309/AJCPEU41HTGXSJDQ

Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy. / Fassan, Matteo; Pizzi, Marco; Farinati, Fabio; Nitti, Donato; Zagonel, Vittorina; Genta, Robert M.; Rugge, Massimo.

In: American Journal of Clinical Pathology, Vol. 137, No. 5, 05.2012, p. 727-732.

Research output: Contribution to journalArticle

Fassan, M, Pizzi, M, Farinati, F, Nitti, D, Zagonel, V, Genta, RM & Rugge, M 2012, 'Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy', American Journal of Clinical Pathology, vol. 137, no. 5, pp. 727-732. https://doi.org/10.1309/AJCPEU41HTGXSJDQ
Fassan, Matteo ; Pizzi, Marco ; Farinati, Fabio ; Nitti, Donato ; Zagonel, Vittorina ; Genta, Robert M. ; Rugge, Massimo. / Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy. In: American Journal of Clinical Pathology. 2012 ; Vol. 137, No. 5. pp. 727-732.
@article{e974ec9a6f2e48dd9f3c555c42ab6679,
title = "Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy",
abstract = "Gastric intraepithelial neoplasia (IEN; formerly dysplasia) is an advanced precancerous lesion. Lesions indefinite for IEN mimic the IEN phenotype but lack some morphologic attributes of IEN. Indefinite for IEN lesions may arise in native foveolae (atypical foveolar hyperproliferation [aFH]) or intestinalized glands (hyperproliferative intestinal metaplasia [HIM]). The clinicopathologic outcome of such lesions is debated. We retrospectively studied the clinicopathologic behavior of 129 consecutive indefinite for IEN lesions (HIM, 98; aFH, 31; median follow-up, 31 months) and correlated outcome with the extent and topography of mucosal atrophy (assessed by OLGA staging) at the initial endoscopy/biopsy. At enrollment, aFH never coexisted with severe/extensive atrophy (all cases were in low-risk OLGA stages [0-II]), whereas HIM was associated with low- and high-risk OLGA stages (0-II, 73; III-IV, 25). At follow-up, IEN was never documented among cases enrolled as aFH, while follow-up endoscopy/biopsy documented 6 neoplastic intraepithelial lesions among 98 cases of HIM (6{\%}, all had high-risk OLGA stages at initial biopsy). OLGA staging can stratify indefinite for IEN lesions into different risk classes, potentially contributing to decisions for a patient-specific follow-up strategy.",
keywords = "Gastritis, Indefinite for intraepithelial neoplasia/dysplasia, OLGA staging, Preneoplastic lesions, Screening",
author = "Matteo Fassan and Marco Pizzi and Fabio Farinati and Donato Nitti and Vittorina Zagonel and Genta, {Robert M.} and Massimo Rugge",
year = "2012",
month = "5",
doi = "10.1309/AJCPEU41HTGXSJDQ",
language = "English (US)",
volume = "137",
pages = "727--732",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
publisher = "American Society of Clinical Pathologists",
number = "5",

}

TY - JOUR

T1 - Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy

AU - Fassan, Matteo

AU - Pizzi, Marco

AU - Farinati, Fabio

AU - Nitti, Donato

AU - Zagonel, Vittorina

AU - Genta, Robert M.

AU - Rugge, Massimo

PY - 2012/5

Y1 - 2012/5

N2 - Gastric intraepithelial neoplasia (IEN; formerly dysplasia) is an advanced precancerous lesion. Lesions indefinite for IEN mimic the IEN phenotype but lack some morphologic attributes of IEN. Indefinite for IEN lesions may arise in native foveolae (atypical foveolar hyperproliferation [aFH]) or intestinalized glands (hyperproliferative intestinal metaplasia [HIM]). The clinicopathologic outcome of such lesions is debated. We retrospectively studied the clinicopathologic behavior of 129 consecutive indefinite for IEN lesions (HIM, 98; aFH, 31; median follow-up, 31 months) and correlated outcome with the extent and topography of mucosal atrophy (assessed by OLGA staging) at the initial endoscopy/biopsy. At enrollment, aFH never coexisted with severe/extensive atrophy (all cases were in low-risk OLGA stages [0-II]), whereas HIM was associated with low- and high-risk OLGA stages (0-II, 73; III-IV, 25). At follow-up, IEN was never documented among cases enrolled as aFH, while follow-up endoscopy/biopsy documented 6 neoplastic intraepithelial lesions among 98 cases of HIM (6%, all had high-risk OLGA stages at initial biopsy). OLGA staging can stratify indefinite for IEN lesions into different risk classes, potentially contributing to decisions for a patient-specific follow-up strategy.

AB - Gastric intraepithelial neoplasia (IEN; formerly dysplasia) is an advanced precancerous lesion. Lesions indefinite for IEN mimic the IEN phenotype but lack some morphologic attributes of IEN. Indefinite for IEN lesions may arise in native foveolae (atypical foveolar hyperproliferation [aFH]) or intestinalized glands (hyperproliferative intestinal metaplasia [HIM]). The clinicopathologic outcome of such lesions is debated. We retrospectively studied the clinicopathologic behavior of 129 consecutive indefinite for IEN lesions (HIM, 98; aFH, 31; median follow-up, 31 months) and correlated outcome with the extent and topography of mucosal atrophy (assessed by OLGA staging) at the initial endoscopy/biopsy. At enrollment, aFH never coexisted with severe/extensive atrophy (all cases were in low-risk OLGA stages [0-II]), whereas HIM was associated with low- and high-risk OLGA stages (0-II, 73; III-IV, 25). At follow-up, IEN was never documented among cases enrolled as aFH, while follow-up endoscopy/biopsy documented 6 neoplastic intraepithelial lesions among 98 cases of HIM (6%, all had high-risk OLGA stages at initial biopsy). OLGA staging can stratify indefinite for IEN lesions into different risk classes, potentially contributing to decisions for a patient-specific follow-up strategy.

KW - Gastritis

KW - Indefinite for intraepithelial neoplasia/dysplasia

KW - OLGA staging

KW - Preneoplastic lesions

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84862596488&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862596488&partnerID=8YFLogxK

U2 - 10.1309/AJCPEU41HTGXSJDQ

DO - 10.1309/AJCPEU41HTGXSJDQ

M3 - Article

C2 - 22523210

AN - SCOPUS:84862596488

VL - 137

SP - 727

EP - 732

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 5

ER -