GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Turk J Gastroenterol. 2022 Feb;33(2):95-102. doi: 10.5152/tjg.2021.201154.
Gastric cancer is one of the most common cancers with high mortality. In Iran, the high-risk regions include Northern and Northwestern parts. The aim of this study was to assess the operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based staging in patients with upper gastrointestinal symptoms.
Totally, 345 patients underwent upper gastrointestinal endoscopy. Also, the status of Helicobacter pylori infection was evaluated using rapid urease test and histological method. Moreover, histological changes were assessed using the Update Sydney System. The operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based stages of 0-II were considered as low-risk stages and stages III and IV were considered as high-risk stages.
Most of the patients were lower than 60 years (245 patients, 71%), and 71.9% of our patients had H. pylori infection. The frequency of atrophic gastritis and intestinal metaplasia was 44.9% and 25.2%, respectively (P < .001). Eleven patients (73.7%) with gastric adenocarcinoma had a low risk and 2 patients with low-grade dysplasia had a high risk of operative link on gastritis assessment and operative link on gastric intestinal metaplasia. Almost, 62.5% of gastric cancer patients with an intestinal type of gastric adenocarcinoma were at low-risk stages.
Although high stages of operative link on gastritis assessment and operative link on gastric intestinal metaplasia need further follow-up, lower stages of atrophy or intestinal metaplasia also require follow-up. Furthermore, operative link on gastritis assessment method in detecting a greater number of patients who need follow-up is more successful and profitable.
胃癌是死亡率较高的最常见癌症之一。在伊朗，高危地区包括北部和西北部。本研究旨在评估以上消化道症状就诊的患者中基于胃炎评估和肠上皮化生的操作链接（operative link on gastritis assessment- and operative link on gastric intestinal metaplasia-based，OLGA）分期系统对评估幽门螺杆菌（Helicobacter pylori，H. pylori）感染的作用。
共 345 例患者接受了上消化道内镜检查。同时，使用快速尿素酶试验和组织学方法评估 H. pylori 感染状况。此外，使用悉尼系统更新版（Update Sydney System）评估组织学变化。OLGA 分期 0-II 被认为是低危分期，而 III-IV 期被认为是高危分期。
大多数患者年龄低于 60 岁（245 例，71%），71.9%的患者感染 H. pylori。萎缩性胃炎和肠上皮化生的发生率分别为 44.9%和 25.2%（P <.001）。11 例（73.7%）胃腺癌患者为低危，2 例低级别上皮内瘤变为高危。OLGA 分期为低危的患者中，近 62.5%的胃腺癌患者具有肠型。
尽管 OLGA 分期较高需要进一步随访，但萎缩或肠上皮化生的较低分期也需要随访。此外，OLGA 分期在检测需要随访的患者数量方面更为成功和有利。
