Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study

Aliment Pharmacol Ther. 2010 May;31(10):1104-11. doi: 10.1111/j.1365-2036.2010.04277.x. Epub 2010 Feb 23.


Background: Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk.

Aim: To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression.

Methods: Ninety-three Italian patients were followed up for more than 12 years (range: 144-204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2).

Results: All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P < 0.001). OLGA-staging at T1 predicted both the OLGA stage (Kaplan-Maier log-rank test, P = 0.001) and the neoplasia at T2 (Kaplan-Maier log-rank test, P = 0.001).

Conclusions: This long-term follow-up study provides the first evidence that gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori-status, gastritis patients could be confidently stratified and managed according to their different cancer risks.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Gastritis / complications
  • Gastritis / epidemiology
  • Gastritis / pathology*
  • Helicobacter Infections / pathology
  • Helicobacter pylori
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Precancerous Conditions / pathology*
  • Prognosis
  • Risk Factors
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / pathology*