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Gastritis staging in clinical practice: the olga staging system
  1. Massimo Rugge (massimo.rugge{at}unipd.it)
  1. University of Padova - Department of Diagnostic Sciences & Special Therapies, Italy
    1. Alberto Meggio
    1. Rovereto Hospital - Gastroenterology Unit, Italy
      1. Gianmaria Pennelli
      1. University of Padova - IOV - Pathology Unit, Italy
        1. Francesco Piscioli
        1. Rovereto Hospital - Department of Pathology, Italy
          1. Luciano Giacomelli
          1. Azienda Ospedaliera di Padova - Pathology Unit, Italy
            1. Giovanni De Pretis
            1. Rovereto Hospital - Gastroenterology Unit, Italy
              1. David Y Graham (dgraham{at}bcm.tmc.edu)
              1. Baylor Collegbe of Medicine - Houston, Texas, United States

                Abstract

                Background & Aims: The available classifications of gastritis are inconsistently used, possibly because none provides immediate prognostic/therapeutic information to clinicians. Based on the fact that the histology reporting of hepatitis in terms of Stage is clinically useful and widely accepted, the International OLGA group proposed an equivalent staging system for reporting gastric histology. Gastritis Staging integrates the atrophy score (obtained by biopsy) and the atrophy topography (achieved through directed biopsy mapping). This prospective cross-sectional study tested whether the OLGA-Staging consistently stratified patients according to their cancer risk and provided clear prognostic/therapeutic information.

                Patients & Methods: The OLGA-Staging for gastric cancer risk (Stage 0 to IV) and Gastritis Grading (overall score of the inflammatory infiltrate: Grade 1 to 4), were applied in 439 prospectively-enrolled, consecutive, dyspeptic outpatients who underwent endoscopy with standardized biopsy sampling. Incidental neoplastic lesions and coexisting peptic ulcers were recorded. Results were presented as Stage (including Antral [A] and Corpus [C] atrophy scores), and H. pylori status (eg, A=3; C=2: Stage IV; Hp+ve).

                Results: Benign conditions (including duodenal ulcers [p<0.001]) consistently clustered in 0-II Stages, whereas all neoplastic (invasive and non-invasive) lesions clustered in Stages III-IV (p<0.001).

                Conclusions: Gastritis Staging, combined with H. pylori status, provided clinically relevant information on the overall status of the gastric mucosa with implication regarding prognosis, therapy, and management.

                • Atrophic gastritis
                • Gastritic precancerous lesions
                • Gastritis
                • Helicobacter pylori
                • Staging and Grading

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