Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Helicobacter. 2017 Dec;22(6). doi: 10.1111/hel.12442. Epub 2017 Sep 22.
BACKGROUND/AIMS: The operative link for gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems are recommended to assess the severity of gastritis, but the optimal biopsy sites have not been clearly defined. We aimed to investigate whether the scoring of the OLGA and OLGIM stages was affected by the use of different biopsy sites.
Between 2014 and 2015, to determine OLGA and OLGIM stages, seven biopsy samples were obtained from the antrum (lesser and greater curvatures [LG] of the antrum and lesser curvature of the angle) and corpus (LG and anterior and posterior walls [AP]) in 247 patients diagnosed with gastritis, gastric adenoma, or adenocarcinoma. The OLGA and OLGIM stages were scored using four different protocols: antrum + angle + corpus LG, antrum + angle + corpus AP, antrum + corpus LG, and antrum + corpus AP. High-risk group included patients who had OLGA or OLGIM stages III and IV.
For the OLGA stage, the angle + antrum + corpus LG protocol placed more patients in the high-risk group (64.4%) than the angle + antrum + corpus AP (55.5%, P < .001), antrum+corpus LG (59.5%, P = .031), and antrum + corpus AP (47.8%, P < .001) protocols. Likewise, for the OLGIM stage, the angle + antrum + corpus LG protocol placed more patients in the high-risk group (48.6%) than the angle + antrum + corpus AP (46.2%, P = .134), antrum + corpus LG (36.8%, P < .001), and antrum + corpus AP (37.2%, P < .001) protocols.
To prevent underestimation of OLGA and OLGIM stages, it is necessary to include an angle biopsy, and to obtain corpus biopsy specimens from lesser and greater curvature sites rather than from anterior and posterior wall sites.
背景/目的：胃炎评估的操作链接（OLGA）和胃肠上皮化生评估的操作链接（OLGIM）分期系统被推荐用于评估胃炎的严重程度，但最佳活检部位尚未明确界定。我们旨在研究不同活检部位的使用是否会影响 OLGA 和 OLGIM 分期的评分。
在 2014 年至 2015 年期间，为了确定 OLGA 和 OLGIM 分期，我们从 247 例诊断为胃炎、胃腺瘤或腺癌的患者的胃窦（小弯和大弯[LG]和角部小弯）和胃体（LG 和前壁和后壁[AP]）获得了七个活检样本。使用四种不同的方案对 OLGA 和 OLGIM 分期进行评分：胃窦+角部+胃体 LG、胃窦+角部+胃体 AP、胃窦+胃体 LG 和胃窦+胃体 AP。高危组包括 OLGA 或 OLGIM 分期为 III 期和 IV 期的患者。
对于 OLGA 分期，角部+胃窦+胃体 LG 方案将更多的患者归入高危组（64.4%），而角部+胃窦+胃体 AP 方案（55.5%，P<.001）、胃窦+胃体 LG 方案（59.5%，P=.031）和胃窦+胃体 AP 方案（47.8%，P<.001）。同样，对于 OLGIM 分期，角部+胃窦+胃体 LG 方案将更多的患者归入高危组（48.6%），而角部+胃窦+胃体 AP 方案（46.2%，P=.134）、胃窦+胃体 LG 方案（36.8%，P<.001）和胃窦+胃体 AP 方案（37.2%，P<.001）。
为了防止 OLGA 和 OLGIM 分期的低估，有必要包括角部活检，并从 LG 而非 AP 部位获取胃体活检标本。
