Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia.
Department of Pathology, School of Medicine, University of Antioquia, Medellín, Colombia.
Virchows Arch. 2022 Apr;480(4):759-769. doi: 10.1007/s00428-022-03286-8. Epub 2022 Jan 28.
Stomach cancer (SC) incidence and mortality are relevant public health issues worldwide. In Colombia, screening for preneoplastic lesions (PNL) and the presence of H. pylori is not routinely performed. Therefore, the aim of this study was to evaluate OLGA-OLGIM staging and the interobserver agreement in gastritis and preneoplastic lesions in patients with gastroduodenal symptoms from Colombia. A cross-sectional study was conducted in 272 patients with gastroduodenal symptoms. Gastric biopsies were taken following the Updated Sydney System with the OLGA-OLGIM classification, and the results were evaluated by two pathologists. Chronic gastritis and PNL were reported in 76% and 24% of the patients, respectively. Furthermore, 25% of the patients with PNL displayed gastric atrophy (GA) and 75% intestinal metaplasia (IM). Agreement in the histopathological reading for IM was good, whereas for OLGA was variable, and for the H. pylori quantity was poor. OLGA-OLGIM stages 0-II were the most frequent (96%), while stage III (4%) and SC (4%) were the least frequent. Age and coffee consumption were associated with a higher prevalence of PNL. This work determined that 4% of the population is at high risk of developing SC and would benefit from follow-up studies. Reinforcement of training programs to improve the agreement in histopathology readings is required.
胃癌(SC)的发病率和死亡率是全球相关的公共卫生问题。在哥伦比亚,并未常规对癌前病变(PNL)和 H. pylori 的存在进行筛查。因此,本研究旨在评估 OLGA-OLGIM 分期以及在有胃十二指肠症状的哥伦比亚患者中胃炎和癌前病变的观察者间一致性。对 272 例有胃十二指肠症状的患者进行了横断面研究。按照更新的悉尼系统对胃活检组织进行了采集,并采用 OLGA-OLGIM 分类进行了评估,由两名病理学家对结果进行了评估。慢性胃炎和 PNL 在患者中分别占 76%和 24%。此外,25%的 PNL 患者存在胃萎缩(GA),75%存在肠上皮化生(IM)。IM 的组织病理学阅读的一致性良好,而 OLGA 的一致性则存在差异,H. pylori 数量的一致性较差。OLGA-OLGIM 0-II 期最常见(96%),而 III 期(4%)和 SC(4%)则最不常见。年龄和咖啡饮用与 PNL 的更高患病率相关。这项工作确定了 4%的人群存在发展为 SC 的高风险,将受益于随访研究。需要加强培训计划以提高组织病理学阅读的一致性。