Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, 19 Raina Blvd, Riga, 1006, Latvia.
Riga East University Hospital, Riga, Latvia.
Virchows Arch. 2021 Oct;479(4):679-686. doi: 10.1007/s00428-021-03116-3. Epub 2021 May 14.
The use of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Assessment based on Intestinal Metaplasia (OLGIM) staging system is recommended for identifying subjects at risk for developing gastric cancer; usually high-risk lesions are considered only as stages III and IV. Accumulating evidence suggests that incomplete intestinal metaplasia (IM) is important in the development of gastric cancer. Our aim has been to identify the prevalence of incomplete IM in patients with low-risk OLGA/OLGIM stages among a high-risk general population. Healthy adult volunteers aged 40-64 years were invited to undergo upper endoscopy within a regional GISTAR pilot study in Kazakhstan (n = 166). Gastric lesions were staged according to OLGA/OLGIM staging system. High iron diamine-alcian blue (HID-AB) was used for subtyping IM. IM prevalence overall was 45.8%. Incomplete IM was present in 52.6% (type II in 30.3% and type III in 22.3%), whereas complete IM was found in 47.4% individuals. The prevalence of OLGIM I and II stage were 39.8 and 4.8%, respectively, whereas OLGIM III was observed in 1.2%. The prevalence of incomplete IM in patients stratified to OLGIM I was 54.5% (type II in 31.8% and type III in 22.7%). High prevalence of incomplete IM was detected not only in subjects with extensive IM, but in those stratified as at the OLGIM I stage. Without IM subtyping, patients with high risk of gastric cancer development would be missed for surveillance.
推荐使用Operative Link on Gastritis Assessment（OLGA）和Operative Link on Gastritis Assessment based on Intestinal Metaplasia（OLGIM）分期系统来评估胃炎，以识别发生胃癌风险的个体；通常仅将高危病变视为 III 期和 IV 期。越来越多的证据表明，不完全肠上皮化生（IM）在胃癌的发生中很重要。我们的目的是在哈萨克斯坦 GISTAR 试点研究中确定高危人群中低风险 OLGA/OLGIM 分期患者中不完全 IM 的患病率。邀请年龄在 40-64 岁的健康成年志愿者参加哈萨克斯坦的区域 GISTAR 试点研究（n=166），进行上消化道内镜检查。根据 OLGA/OLGIM 分期系统对胃病变进行分期。高铁二胺-粘蛋白蓝（HID-AB）用于 IM 亚型分类。总体 IM 患病率为 45.8%。不完全 IM 占 52.6%（II 型占 30.3%，III 型占 22.3%），而完全 IM 占 47.4%。OLGIM I 和 II 期的患病率分别为 39.8%和 4.8%，而 OLGIM III 期的患病率为 1.2%。OLGIM I 分层患者中不完全 IM 的患病率为 54.5%（II 型占 31.8%，III 型占 22.7%）。不仅在广泛 IM 的患者中检测到不完全 IM 的高患病率，而且在分层为 OLGIM I 期的患者中也检测到不完全 IM 的高患病率。如果不进行 IM 亚型分类，就会错过对有发展为胃癌风险的患者进行监测的机会。
