Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University Seoul, South Korea.
Helicobacter. 2018 Dec;23(6):e12542. doi: 10.1111/hel.12542. Epub 2018 Oct 10.
The operative link on gastric atrophy (OLGA) and operative link on gastric intestinal metaplasia (OLGIM) stages have been suggested for risk estimation of gastric cancer (GC). However, usefulness of OLGA/OLGIM systems in diffuse type of GC was not investigated so far. The aims of this study were to evaluate the OLGA/OLGIM systems in estimating the GC risk according to Lauren's classification and to investigate the interaction among the risk factors.
The OLGA/OLGIM stages were evaluated in 1398 (765 control and 633 GC patients) who were prospectively enrolled in the Seoul National University Bundang Hospital. Synergistic interaction among the risk factors for GC was calculated using an additive model.
Among 387 intestinal-type GC patients, 71 (18.3%) were high-risk OLGA stages (III, IV) and 113 (29.2%) were high-risk OLGIM stages (III, IV). Of the 246 patients with diffuse-type GC, 36 (14.6%) were high-risk OLGA stages and 39 (15.9%) were high-risk OLGIM stages. Multivariable analysis revealed family history of GC, Helicobacter pylori infection, high-risk OLGA stages, and high-risk OLGIM stages as independent risk factors for GC regardless of histologic type (odds ratios [ORs] 1.78, 1.94, 2.63, and 3.18, respectively). There was no significant risk modification among the H. pylori infection, family history of GC, and high-risk OLGA/OLGIM stages.
High-risk OLGA/OLGIM stages are important prediction markers for GC regardless of H. pylori infection or family history of GC not only for the intestinal type but also for diffuse-type GC.
已经提出了用于估计胃癌（GC）风险的操作链接胃萎缩（OLGA）和操作链接胃肠上皮化生（OLGIM）阶段。然而，到目前为止，还没有研究 OLGA/OLGIM 系统在弥漫型 GC 中的作用。本研究的目的是根据 Lauren 分类评估 OLGA/OLGIM 系统在估计 GC 风险中的作用，并研究危险因素之间的相互作用。
前瞻性纳入首尔国立大学盆唐医院的 1398 例（765 例对照和 633 例 GC 患者），评估 OLGA/OLGIM 分期。使用加性模型计算 GC 危险因素之间的协同交互作用。
在 387 例肠型 GC 患者中，71 例（18.3%）为高危 OLGA 分期（III、IV 期），113 例（29.2%）为高危 OLGIM 分期（III、IV 期）。246 例弥漫型 GC 患者中，36 例（14.6%）为高危 OLGA 分期，39 例（15.9%）为高危 OLGIM 分期。多变量分析显示，GC 家族史、幽门螺杆菌感染、高危 OLGA 分期和高危 OLGIM 分期是 GC 的独立危险因素，无论组织学类型如何（比值比[OR]分别为 1.78、1.94、2.63 和 3.18）。幽门螺杆菌感染、GC 家族史和高危 OLGA/OLGIM 分期之间没有显著的风险修饰作用。
高危 OLGA/OLGIM 分期是 GC 的重要预测标志物，无论是否存在幽门螺杆菌感染或 GC 家族史，不仅对肠型而且对弥漫型 GC 都有重要意义。
