Article Text
PDF
Statistics from Altmetric.com
We read with great interest the article by Lee et al 1 evaluating the risk of progression from chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) to high-grade dysplasia (HGD) or gastric adenocarcinoma (GA), according to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) staging system. Patients with OLGIM III–IV had a substantially increased risk of HGD/GA, with a median time to progression of 22.7 months, while patients with OLGIM II had an intermediate risk. These findings complement the results by Rugge et al, 2 demonstrating a higher risk of neoplastic progression among patients with Operative Link on Gastritis Assessment (OLGA) III–IV, but not OLGA II.
Studies directly comparing the predictive value of both OLGA and OLGIM systems in the same cohort are scarce.3 4 We leveraged the ‘Endoscopic Cohort and Histological OLGA staging’ (trial: NCT05969444) to compare the predictive capability of OLGA versus OLGIM for HGD/GA. We included 685 Chilean adults who underwent an oesophagogastroduodenoscopy with gastric mapping biopsies, and who subsequently had at least one endoscopic surveillance examination with mapping biopsies completed at least 6 months apart (table 1). The primary outcome was histologically confirmed incident HGD or GA according to baseline OLGA and OLGIM stages (assessed by two experienced pathologists). The kappa values for interpathologist and intrapathologist agreement were 0.63 and 0.71 for …
Footnotes
SCS and AR are joint senior authors.
X @GonzaloLatorreS, @jivargasd
SCS and AR contributed equally.
Contributors GL, FS, JU, MP, PA, AHC, RC, AE, MCC, SS and AR conceived and designed the study. GL, JU, OCS, DR, PA, AD, RC, CA, RG, JIV, AE and AR recruited patients and performed oesophagogastroduodenoscopy. GL, FS, IM, MB, ED, JU, OCS, DR and SP collected data. JT, JCR and SP performed histopathological analysis. GL, EF-L, IW, AHC, RC, AE, MCC, SS and AR analysed the data. GL, FS, MP, PM, SP, PA, IW, AHC, RC, CA, AE, MCC, SS and AR wrote the manuscript. GL, FS, IM, MB, ED, JU, OCS, DR, EF-L, MP, PM, JT, JCR, SP, PA, AD, IW, AHC, JC, RC, CA, RG, JIV, AE, MCC, SS and AR reviewed the manuscript.
Funding FONIS SA19/0188 (AR), FONDECYT no 11201338 (PA), European Union’s Horizon 2020 research and innovation program grant agreement no 825832 (AR), FONDECYT 1230504 (AR, GL, AHC, JCR, SS), ANID FONDAP 152220002 (AR, JCR), FONDECYT 1231773 (AHC, AR), CONICYT-FONDAP 15130011 (AHC, IW), American Gastroenterological Association Research Scholar Award (2019) (SS), Veterans Affairs Career Development Award (ICX002027A01) (SS) and San Diego Digestive Diseases Research Center (NIH P30 DK120515) (SS).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.