OLGA Gastritis Staging for the Prediction of Gastric Cancer Risk: A Long-term Follow-up Study of 7436 Patients

Massimo Rugge, Robert M Genta, Matteo Fassan, Elisa Valentini, Irene Coati, Stefano Guzzinati, Edoardo Savarino, Manuel Zorzi, Fabio Farinati, Peter Malfertheiner

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29 Scopus citations

Abstract

Objectives: Gastritis OLGA-staging ranks the risk for gastric cancer (GC) in progressive stages (0–IV). This long-term follow-up study quantifies the GC risk associated with each OLGA stage. Methods: Consecutive patients (7436) underwent esophagogastroscopy (T-0), with mapped gastric biopsies, OLGA staging, and H. pylori status assessment. Patients with neoplastic lesion (invasive or non-invasive) at the index endoscopy (and/or within 12 months) were excluded. All patients were followed-up (T-1) by combining different sources of clinical/pathological information (Regional Registries of: (i) esophagogastroduodenoscopies; (ii) pathology reports; (iii) cancer, (iv) mortality). The endpoint was histologically documented development of gastric epithelial neoplasia. Results: At T-0, the patients’ distribution by OLGA stage was: Stage 0 = 80.8%; Stage I = 12.6%; Stage II = 4.3%; Stage III = 2.0%; Stage IV = 0.3%; H. pylori infection was detected in 25.9% of patients. At the end of the follow-up (mean/median = 6.3/6.6 years), 28 incident neoplasia were documented (overall prevalence = 0.60 per 103/person-years; low-grade intraepithelial neoplasia = 17/28; high-grade intraepithelial neoplasia = 4/28; GC = 7/28). By OLGA stage at the enrollment, the rate of incident neoplasia was: Stage 0 = 1 case; rate/103 person-years = 0.03; 95%CI: 0.004–0.19; Stage I = 2 cases; rate/103 person-years = 0.34; 95%CI: 0.09–1.36; Stage II = 3 cases; rate/103 person-years = 1.48; 95%CI: 0.48–4.58; Stage III = 17 cases; rate/103 person-years = 19.1; 95%CI: 11.9–30.7; Stage IV = 5 cases; rate/103 person-years = 41.2; 95%CI: 17.2–99.3. Multivariate analysis including gender, age, H. pylori status, and OLGA stage at enrollment only disclosed OLGA stage as predictor of neoplastic progression (OLGA stage III: HR = 712.4, 95%CI = 92.543–5484.5; OLGA stage IV: HR = 1450.7, 95%CI = 166.7–12626.0). Conclusions: Among 7436 patients, OLGA stages at the enrollment correlated significantly with different risk for gastric neoplasia. Based on the obtained results, gastritis staging is a critical adjunct in endoscopy follow-up protocols aimed at GC secondary prevention.

Original languageEnglish (US)
Pages (from-to)1621-1628
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume113
Issue number11
DOIs
StatePublished - Nov 1 2018

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Rugge, M., Genta, R. M., Fassan, M., Valentini, E., Coati, I., Guzzinati, S., Savarino, E., Zorzi, M., Farinati, F., & Malfertheiner, P. (2018). OLGA Gastritis Staging for the Prediction of Gastric Cancer Risk: A Long-term Follow-up Study of 7436 Patients. American Journal of Gastroenterology, 113(11), 1621-1628. https://doi.org/10.1038/s41395-018-0353-8