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OLGA 和 OLGIM 分期系统在胃癌风险评估中的意义:系统评价和荟萃分析。

The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis.

机构信息

Department of Gastroenterology, First Affiliated Hospital of Zhejiang, Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, China.

Key Laboratory of Digestive Pathophysiology of Zhejiang Province, First Affiliated Hospital of Zhejiang, Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, China.

出版信息

Gastric Cancer. 2018 Jul;21(4):579-587. doi: 10.1007/s10120-018-0812-3. Epub 2018 Feb 19.

Abstract

BACKGROUND

Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available.

AIM

To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk.

METHODS

We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures.

RESULTS

A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant.

CONCLUSIONS

This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.

摘要

背景

尽管已经对使用胃炎评估操作链接(OLGA)和胃炎/肠上皮化生评估操作链接(OLGIM)系统评估胃癌风险的标准进行了广泛的研究,但目前尚无关于其使用的综合概述或系统总结。

目的

进行系统评价和荟萃分析,以评估 OLGA 和 OLGIM 分期系统在评估胃癌风险中的疗效。

方法

我们搜索了各种数据库,包括 PubMed、EMBASE、Medline 和 Cochrane 图书馆,以获取 2017 年 3 月之前发表的关于 OLGA/OLGIM 分期与胃癌风险之间关联的文章。使用 RevMan 5.30 和 Stata 14.0 进行统计分析,使用比值比、风险比和 95%置信区间作为效应量。

结果

对 6 项病例对照研究和 2 项队列研究进行了荟萃分析,共纳入 2700 例患者。前瞻性病例对照研究的荟萃分析表明,OLGA/OLGIM 分期 III/IV 与胃癌之间存在显著关联。OLGA 的病例对照研究的纽卡斯尔-渥太华量表(NOS)评分反映了异质性。高质量(NOS 评分≥5)研究的亚组分析显示 OLGA 分期 III/IV 与胃癌风险增加之间存在关联;在 NOS 评分较低的其余研究中,这种关联也很高。OLGA 定义的较高胃炎分期与胃癌风险之间存在显著相关性。

结论

这种相关性表明,有必要对这些高危患者进行密切和频繁的监测,以促进胃癌的及时诊断。

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