The Orientation of Gastric Biopsy Samples Improves the Interobserver Agreement of the OLGA Staging System

Cotruta, Bogdan; Gheorghe, Cristian; Iacob, Răzvan; Dumbravă, Mona; Radu, Carmen; Băncilă, Ion; Becheanu, Gabriel

doi:10.15403/jgld.2014.1121.264.olg

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…2 High grade dysplasia and invasive carcinoma should be regarded as the outcomes to be prevented when patients with chronic atrophic gastritis or intestinal metaplasia are managed 11 Family history of gastric cancer should be taken into account in the follow-up of precancerous conditions ▶ [23]. OLGIM III and IV stages may thus identify patients at a higher risk for gastric cancer [18,19].…”

Section: Maps I Maps Ii (In Bold If Modified)mentioning

confidence: 99%

Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019

et al. 2019

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Main RecommendationsPatients with chronic atrophic gastritis or intestinal metaplasia (IM) are at risk for gastric adenocarcinoma. This underscores the importance of diagnosis and risk stratification for these patients. High definition endoscopy with chromoendoscopy (CE) is better than high definition white-light endoscopy alone for this purpose. Virtual CE can guide biopsies for staging atrophic and metaplastic changes and can target neoplastic lesions. Biopsies should be taken from at least two topographic sites (antrum and corpus) and labelled in two separate vials. For patients with mild to moderate atrophy restricted to the antrum there is no evidence to recommend surveillance. In patients with IM at a single location but with a family history of gastric cancer, incomplete IM, or persistent Helicobacter pylori gastritis, endoscopic surveillance with CE and guided biopsies may be considered in 3 years. Patients with advanced stages of atrophic gastritis should be followed up with a high quality endoscopy every 3 years. In patients with dysplasia, in the absence of an endoscopically defined lesion, immediate high quality endoscopic reassessment with CE is recommended. Patients with an endoscopically visible lesion harboring low or high grade dysplasia or carcinoma should undergo staging and treatment. H. pylori eradication heals nonatrophic chronic gastritis, may lead to regression of atrophic gastritis, and reduces the risk of gastric cancer in patients with these conditions, and it is recommended. H. pylori eradication is also recommended for patients with neoplasia after endoscopic therapy. In intermediate to high risk regions, identification and surveillance of patients with precancerous gastric conditions is cost-effective.

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Section: Maps I Maps Ii (In Bold If Modified)mentioning

confidence: 99%

Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019

et al. 2019

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“…PPM was defined as the replacement of the oxyntic glands by glands resembling the muco-secreting cell-lined glands normally present in the antral region (29). The reliability of this approach to assess IM and PPM has been previously reported (30)(31)(32).…”

Section: Histopathological Assessmentmentioning

confidence: 78%

Pseudopyloric Metaplasia Is Not Associated With the Development of Gastric Cancer

Dilaghi¹,

Baldaro²,

Pilozzi

et al. 2021

Am J Gastroenterol

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INTRODUCTION: Corpus atrophic gastritis (CAG) is associated with intestinal metaplasia (IM) and pseudopyloric metaplasia (PPM). Prospective data on corpus mucosa PPM and its link to the development of gastric cancer (GC) are lacking. This study aimed to investigate the relationship between the presence of corpus mucosa PPM at baseline and the development of GC at follow-up in patients with CAG. METHODS: A longitudinal cohort study was conducted on patients with consecutive CAG adhering to endoscopic-histological surveillance. Patients were stratified for the presence/absence of corpus PPM without concomitant corpus IM at baseline, and the occurrence of gastric neoplastic lesions at the longest available follow-up was assessed. RESULTS: A total of 292 patients with CAG with a follow-up of 4.2 (3–17) years were included. At baseline, corpus PPM without corpus IM was diagnosed in 62 patients (21.2%). At the follow-up, GC was detected in 5 patients (1.7%) and gastric dysplasia (GD) in 4 patients (1.4%). In all these 9 patients with GC/GD at the follow-up, corpus IM was present at baseline and follow-up. Age <50 years (odds ratio [OR] 2.5), absence of pernicious anemia (OR 4.3), and absence of severe corpus atrophy (OR 2.3) were associated with corpus PPM without corpus IM. DISCUSSION: At the 4.2-year follow-up, in patients with CAG characterized at baseline with corpus PPM without corpus IM, GC or GD was not observed because these lesions were consistently associated with corpus IM. Corpus PPM without corpus IM was associated with younger age, absence of pernicious anemia, and severe corpus atrophy, suggesting a lower stage of disease progression. Corpus PPM alone seems not to be associated with GC, whose development seems to require the presence of corpus IM as a necessary step.

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“…Moreover, crush artifacts in gastric biopsy specimens could decrease the quality of specimens, [22] and incorrect orientation of the biopsy samples inevitably affected the morphometric evaluation. [1,23] Therefore, to avoid the above difficulties of biopsy tissues, surgical gastric specimens with full-thickness mucosa were utilized in the study. Gastric atrophy is defined as the loss of "appropriate glands."…”

Section: Discussionmentioning

confidence: 99%

Morphometric features of gastric mucosa in atrophic gastritis: A different pattern between corpus and antrum

Lin

Wang

et al. 2023

Medicine

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Atrophic gastritis can cause mucosa thinning, while detailed metrological evidence is lacking. We aimed to compare the morphological features of full-thickness gastric mucosa in antrum and corpus and evaluate the diagnostic performance for atrophy. Gastric cancer patients were prospectively enrolled (N = 401). Full-thickness gastric mucosa was obtained. Foveolar length, glandular length and musculus mucosae thickness were measured. Pathological assessment was conducted using the visual analogue scale of the updated Sydney system. Areas under the receiver operating characteristic curves (AUCs) were calculated for different atrophy degrees. In corpus mucosa, foveolar length and musculus mucosae thickness were positively correlated with the atrophy degree (spearman’s correlation coefficient [ r s ] = 0.231 and 0.224, respectively, P < .05); glandular length and total mucosal thickness were negatively correlated ( r s = −0.399 and −0.114, respectively, P < .05). Total mucosal thickness did not correlate with antral atrophy degree ( P = .107). The AUCs of total mucosal thickness for corpus and antral atrophy were 0.570 ( P < .05) and 0.592 ( P < .05), respectively. The AUCs for corpus atrophy, moderate and severe, and severe atrophy were 0.570 ( P < .05), 0.571 ( P = .003), and 0.584 ( P = .006), respectively. The corresponding AUCs for antral atrophy were 0.592 ( P = .010), 0.548 ( P = .140), and 0.521 ( P = .533), respectively. The tendency for mucosal thickness to thin with atrophy occurred in the corpus rather than in the antrum. The diagnostic performance of corpus and antral mucosal thickness was limited for atrophy.

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The Orientation of Gastric Biopsy Samples Improves the Interobserver Agreement of the OLGA Staging System

Cited by 14 publications

References 16 publications

Pseudopyloric Metaplasia Is Not Associated With the Development of Gastric Cancer

Morphometric features of gastric mucosa in atrophic gastritis: A different pattern between corpus and antrum

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