OLGA- and OLGIM-based staging of gastritis using narrow-band imaging magnifying endoscopy

Dig Endosc. 2015 Nov;27(7):734-41. doi: 10.1111/den.12483. Epub 2015 Jun 8.


Background and aim: As atrophic gastritis and intestinal metaplasia as a result of Helicobacter pylori are considered risk factors for gastric cancer, it is important to assess their severity. In the West, the operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) staging systems based on biopsy have been widely adopted. In Japan, however, narrow-band imaging (NBI)-magnifying endoscopic diagnosis of gastric mucosal inflammation, atrophy, and intestinal metaplasia has been reported to be fairly accurate. Therefore, we investigated the practicality of NBI-magnifying endoscopy (NBI-ME) for gastritis staging.

Methods: We enrolled 55 patients, in whom NBI-ME was used to score the lesser curvature of the antrum (antrum) and the lesser curvature of the lower body (corpus). The NBI-ME score classification was established from images obtained beforehand, and then biopsy specimens taken from the observed areas were scored according to histological findings. The NBI-ME and histology scores were then compared. Furthermore, we assessed the NBI-ME and histology stages using a combination of scores for the antrum and corpus, and divided the stages into two risk groups: low and high. The degree to which the stage assessed by NBI-ME approximated that assessed by histology was then ascertained.

Results: Degree of correspondence between the NBI-ME and histology scores was 69.1% for the antrum and 72.7% for the corpus, and that between the high- and low-risk groups was 89.1%.

Conclusion: Staging of gastritis using NBI-ME approximates that based on histology, and would be a practical alternative to the latter.

Keywords: gastritis; magnifying endoscopy; narrow-band imaging; operative link for gastric intestinal metaplasia assessment (OLGIM); operative link for gastritis assessment (OLGA).

MeSH terms

  • Atrophy / diagnosis
  • Biopsy
  • Cardia / pathology
  • Cross-Sectional Studies
  • Diagnosis, Computer-Assisted
  • Diagnosis, Differential
  • Equipment Design
  • Gastric Mucosa / pathology*
  • Gastritis / pathology*
  • Gastroscopes*
  • Gastroscopy / methods*
  • Humans
  • Metaplasia / diagnosis
  • Narrow Band Imaging / methods*
  • Pyloric Antrum / pathology
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Severity of Illness Index
  • Stomach Neoplasms / diagnosis