Benites-Goñi Harold, Cabrera-Hinojosa Dacio, Latorre Gonzalo, Hernandez Adrian V, Uchima Hugo, Riquelme Arnoldo
Unidad de Revisiones Sistemáticas y Meta-análisis, Universidad San Ignacio de Loyola, Avenida La Fontana 550, 15024, Lima, Peru.
Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Therap Adv Gastroenterol. 2025 Mar 18;18:17562848251325461. doi: 10.1177/17562848251325461. eCollection 2025.
The Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) are established classification systems used to evaluate atrophic gastritis and intestinal metaplasia, respectively.
We evaluated the association of OLGA and OLGIM scores and the risk of gastric cancer (GC) in only prospective cohort studies.
Systematic review and meta-analysis.
We systematically searched four databases for prospective cohorts that evaluated the use of OLGA and OLGIM staging systems in predicting the risk of GC. We primarily compared OLGA/OLGIM III-IV versus OLGA/OLGIM 0-II categories and GC events. Pooled risk ratios (RR) and absolute risk differences with their 95% confidence intervals (CIs) were calculated.
Eight studies were included ( = 12,526). The mean age of the patients ranged from 48.2 to 64.9 years. OLGA III-IV and OLGIM III-IV were associated with the development of GC in comparison to their 0-II categories (RR 32.31, 95% CI 9.14-114.21 and RR 12.38, 95% CI 5.75-26.65, respectively). OLGA III-IV and OLGIM III-IV were associated with an increase in the absolute risk of GC of 4% and 5%, respectively. The risk remained significant if we only included countries with high incidence of GC, and was greater if we excluded one study that included mostly patients with autoimmune gastritis. OLGA II and OLGIM II were associated with higher risk of high-grade dysplasia (HGD) and GC in comparison with OLGA 0-I and OLGIM 0-I, respectively.
Higher stages in OLGA and OLGIM systems are associated with a significantly increased risk of developing HGD and GC, validating these scoring systems for the assessment of GC risk and the design of endoscopic surveillance programs.
CRD42024565771.
胃炎评估手术链接（OLGA）和胃肠化生评估手术链接（OLGIM）是分别用于评估萎缩性胃炎和肠化生的既定分类系统。
我们仅在前瞻性队列研究中评估了OLGA和OLGIM评分与胃癌（GC）风险的关联。
系统评价和荟萃分析。
我们系统检索了四个数据库，以查找评估OLGA和OLGIM分期系统在预测GC风险中的应用的前瞻性队列。我们主要比较了OLGA/OLGIM III-IV与OLGA/OLGIM 0-II类别以及GC事件。计算合并风险比（RR）和绝对风险差异及其95%置信区间（CI）。
纳入八项研究（n = 12,526）。患者的平均年龄在48.2至64.9岁之间。与0-II类别相比，OLGA III-IV和OLGIM III-IV与GC的发生相关（RR分别为32.31，95%CI 9.14-114.21和RR 12.38，95%CI 5.75-26.65）。OLGA III-IV和OLGIM III-IV分别与GC绝对风险增加4%和5%相关。如果仅纳入GC高发国家，该风险仍然显著，如果排除一项主要纳入自身免疫性胃炎患者的研究，风险则更大。与OLGA 0-I和OLGIM 0-I相比，OLGA II和OLGIM II分别与高级别上皮内瘤变（HGD）和GC的较高风险相关。
OLGA和OLGIM系统中的较高阶段与发生HGD和GC的风险显著增加相关，验证了这些评分系统在评估GC风险和设计内镜监测计划方面的有效性。
试验PROSPERO注册：CRD42024565771。
