Autoimmune gastritis: histology phenotype and <scp>OLGA</scp> staging

Rugge, Massimo; Fassan, Matteo; Pizzi, Marco; Zorzetto, V.; Maddalo, G.; Realdon, Stefano; Bernard, Marina de; Betterle, Corrado; Cappellesso, Rocco; Pennelli, Gianmaria; Boni, Michele De; Farinati, Fabio

doi:10.1111/j.1365-2036.2012.05101.x

Cited by 108 publications

(66 citation statements)

References 31 publications

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“…Nonetheless, natural history of AAG histopathological lesions had been poorly described before, and most of our knowledge in this regard is restricted to observational studies in patients with pernicious anaemia . In only one retrospective study, among 116 PCA positive patients undergoing follow‐up upper gastrointestinal endoscopy within a mean time of 54 months, 22% showed stage progression assessed by operative link for gastritis assessment (OLGA) staging system, with younger patients generally showing milder gastric lesions . However, patients with H pylori infection, and without atrophy at the time of the first evaluation were included, thus making it difficult to compare these results with our findings.…”

Section: Discussionmentioning

confidence: 92%

Natural history of autoimmune atrophic gastritis: a prospective, single centre, long‐term experience

Miceli

Vanoli

Lenti

et al. 2019

Aliment Pharmacol Ther

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Summary Background Autoimmune atrophic gastritis (AAG) is an immune‐mediated disorder characterised by destruction of gastric oxyntic mucosa Aim To explore gastric histopathological evolution in a cohort of AAG patients over a prolonged follow‐up Methods Single centre prospective study enrolling consecutive patients with histologically confirmed AAG between 2000 and 2018. All AAG patients undergoing endoscopic follow‐up every 1‐3 years were classified as having stages 1, 2 or 3 according to atrophy severity (mild, moderate and severe). AAG patients with either glandular or neuroendocrine dysplasia/neoplasia were classified as having stage 4. Disease stage progression, and changes in serum anti‐parietal cell antibody (PCA), chromogranin A and gastrin‐17 were assessed. Results In total, 282 AAG patients (mean age 60.3 years; F:M ratio 2.4:1; median follow‐up 3 years, interquartile range 1‐7) were enrolled. All patients with stages 1 or 2 progressed to stage 2 or 3 over time with a steady trend (P = .243) and regression from a severe to a milder stage was never noticed. Disease progression of patients with stages 1 or 2 occurred within the first 3 years. PCA positivity rate did not change over time. Stage 3 patients had higher gastrin‐17 levels compared to patients with stages 1 and 2 (median 606 vs 295 pg/mL; P < .001). In stage 3, the hazard ratio for the risk of developing stage 4 was 6.6 (95% CI 1.5‐29; P = .001). Conclusions AAG is a steadily progressive disease, in which stages 1 and 2 always progress to stage 3. The risk of developing a complicated disease stage is greater in patients with more severe gastric lesions.

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Section: Discussionmentioning

confidence: 92%

Natural history of autoimmune atrophic gastritis: a prospective, single centre, long‐term experience

Miceli

Vanoli

Lenti

et al. 2019

Aliment Pharmacol Ther

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“…In a recent meta‐analysis, the pooled GC incidence‐rate among patients with PA was of 0.27% per person‐years, with an overall GC relative risk of 6.8 (95% CI: 2.6–18.1) . However, PA may result also from disorders other than AIG, including H. pylori gastritis . On the other hand, the risk of developing GC among patients with exclusively AIG has not been reported so far.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune gastritis in autoimmune thyroid disease

Venerito

Radünz

Reschke

et al. 2015

Aliment Pharmacol Ther

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“…Less commonly, gastric atrophy of the oxyntic mucosa results from a primary autoimmune disease targeting the oxyntic parietal cells (the so‐called corpus‐restricted [autoimmune] atrophic gastritis) …”

Section: Gastric Mucosal Inflammation and Atrophy As Field(s) Of Canmentioning

confidence: 99%

Gastric cancer prevention targeted on risk assessment: Gastritis OLGA staging

et al. 2019

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Gastric cancer (GC) ranks among the most lethal epithelial malignancies, and its striking mortality rate prompts a global prevention strategy. Helicobacter pylori (H. pylori) gastritis is the main GC promoter, and the 2014 Global Kyoto conference recognized H. pylori gastritis as a (treatable) infectious disease. It is therefore plausible that any large‐scale intervention for H. pylori eradication would result in cleansing the world of the fifth cause of cancer‐related death. Atrophic gastritis is the cancerization field in which GCs (both intestinal and diffuse histotypes) mainly develop. Discontinuing the inflammatory cascade triggered by H. pylori is tantamount to preventing GC. For patients (still infected or eradicated) who have already developed gastric atrophy, the severity/topography of the atrophic changes correlates with their cancer risk. Gastritis OLGA (Operative Link for Gastritis Assessment) staging consistently ranks the atrophy‐associated cancer risk, providing a solid clinical/biological rationale for establishing patient‐specific surveillance programs. By combining primary and secondary prevention strategies, gastric cancer is a preventable disease.

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Autoimmune gastritis: histology phenotype and OLGA staging

Abstract: SUMMARY BackgroundAmong Western populations, the declining incidence of Helicobacter pylori infection coincides with a growing clinical impact of autoimmune gastritis.

Cited by 108 publications

References 31 publications

Natural history of autoimmune atrophic gastritis: a prospective, single centre, long‐term experience

Natural history of autoimmune atrophic gastritis: a prospective, single centre, long‐term experience

Autoimmune gastritis in autoimmune thyroid disease

Gastric cancer prevention targeted on risk assessment: Gastritis OLGA staging

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