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A new staging system has performed well in an initial validation study, signalling a big step forward in the care and treatment of patients at risk of gastric cancer.
The system, devised by an international group of gastroenterologists and pathologists (OLGA), and based on a synthesis of the extent and location of histological atrophy of the gastric mucosa, successfully distinguished between patients with gastric cancer and those with benign conditions. Cancerous invasive or non‐invasive lesions, present in 21/439 patients, clustered exclusively in OLGA stages III/IV whereas benign conditions like duodenal and gastric ulcers clustered in stages 0–II.
OLGA stage should in future be stated at the end of histological reports, plus Helicobacter pylori status (positive/negative/suspected) or other possible cause or important risk factor for gastric cancer.
The prospective cross sectional study was carried out during one year on consecutive outpatients with dyspepsia at a gastroenterology clinic of one hospital in Padua, Italy. Each had biopsy specimens taken of lesions in the upper gastrointestinal tract.
Modelled on a successful staging system for reporting on hepatitis, the OLGA system was devised to replace existing systems for reporting chronic atrophic gastritis that are inconsistently used and do not provide useful information on disease outcome. It relies on standardised biopsy sampling and histological scoring of atrophic disease to provide an index of mucosal atrophy, representing disease progression, combined with mapping of the atrophy within the gastrointestinal tract.
Multicentre trials are now needed to confirm these results for other populations.
Rugge M, et al. Gut 2007;56:631–636.
Please visit the Journal of Clinical Pathology website [www. jclinpath.com] for a link to the full text of this article.