The OLGIMA system for gastric cancer risk assessment. A useful method based on the histological Sydney consensus
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: The risk stratification of gastric cancer (GC) is graded by assessing well-established precursor lesions, glandular atrophy (GA), and intestinal metaplasia (IM), resulting in both the operative link on gastritis assessment (OLGA), and intestinal metaplasia (OLGIM) systems. Although the OLGIM stage is reproducible among pathologists, the OLGA system is laborious to calculate and has poor reproducibility. In addition, it does not comprehensively address the severity of both GA and IM as recommended by the Sydney consensus. We aimed to propose the Operative Link on Gastric Intestinal Metaplasia and Glandular Atrophy Assessment (OLGIMA) system, which identifies OLGIM III-IV and upstages 0-II with advanced GA. METHODS: A cross-sectional study of consecutive diagnostic gastroscopies in adults was designed. Systematic gastric biopsies were taken. The updated Sydney guidelines were used for histological grading of GA and IM. Higher GC risk was defined as OLGIM III-IV and advanced GA. RESULTS: The OLGIMA stage was assessed based on the most severe GA and/or IM findings in both antrum and corpus. We included 998 patients (median age 57; 64% women; 35% Helicobacter pylori infection). Thirty-nine (3.9%) patients had higher GC risk: 17 (1.7%) with OLGIM III-IV; 12 (1.2%) with advanced GA, and 10 (1%) meeting both criteria. Among OLGIM 0-II, 12 (1.2%) patients had advanced GA. The OLGIMA system upstaged 39 (3.9%) patients to III-IV, being more sensitive than OLGIM. CONCLUSIONS: The new OLGIMA system identifies patients at higher GC risk (OLGIMA III-IV), encompassing all OLGIM III-IV patients, and upstaging those OLGIM 0-II with advanced GA. This approach addresses the OLGA and OLGIM limitations by integrating GA and IM severity as recommended by the Updated Sydney consensus.
Source: Histopathology
DOI: 10.1111/his.70042
Authors: Pedro Genaro Delgado Guillena, Miriam Cuatrecasas, Sheyla Montori, Nayra Felipez Varela, Joan Llach, Iva Archilla, Pablo Florez‐Diez, Eva Barreiro‐Alonso, Javier Tejedor‐Tejada, Raquel Vicente, M Teresa Soria, Alaín Huerta, Silvia Patricia Ortega, Henar Nuñez, Oliver Patrón, Carolina Mangas, Diana Zaffalon, Luis Hernández, Luis Enrique Yip, Gadea Hontoria, Gonzalo Hijos, Maria Jose Domper‐Arnal, Sara Zarraquiños, Alberto Herreros De Tejada, Alicia Córdoba, Anabella Cuestas, Glòria Fernández‐Esparrach, Leticia Moreira, Eduardo Albéniz
Institutions: Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Universidad Pública de Navarra (UPNA), Navarrabiomed, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Hospital Universitario De Cabueñes, Hospital Universitario Miguel Servet, University of the Basque Country, BioCruces Health research Institute, Hospital de Galdakao, Hospital Comarcal de Inca, Hospital Universitario Río Hortega, Servei de Salut de les Illes Balears, Hospital General Universitario de Alicante Doctor Balmis, Consorci Sanitari de Terrassa, Hospital Universitario de Burgos, Universidad de Burgos, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón, Centro de Investigación Biomédica en Red, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Navarre Institute of Health Research
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,840
Funder: Instituto de Salud Carlos III
OpenAlex ID: W4416723616