First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia
Alimentary Pharmacology and Therapeutics, 05/10/2012
Marcos–Pinto P et al. – First–degree relatives (FDRs) of early–onset gastric carcinoma (EOGC) patients have, even at young ages, a high prevalence of H. pylori infection, high–risk Operative Link on Gastritis (OLGA) and Operative Link on Intestinal Metaplasia Assessment (OLGIM) stages and dysplasia. These patients should undergo accurate endoscopic observation with at least four biopsies in antrum and corpus to allow adequate staging and follow–up of premalignant conditions and lesions scored in high–risk stages, in accordance with international guidelines recently proposed.Methods
- A case-control study was conducted encompassing 103 FDRs of EOGC patients (cases) and 101 age- and gender-matched controls, all submitted to upper GI endoscopy and OLGA and OLGIM used for staging as well as modified versions with exclusion of the biopsies from incisura angularis in the analysis.
- Helicobacter pylori infection was present in 82% of cases (P = 0.001).
- Atrophy was present in 70% of cases (OLGA stages I-IV).
- High-risk stages (III-IV) were identified only in cases (19%) (P < 0.001).
- Dysplasia was diagnosed only in cases (n = 7, P = 0.007).
- The application of OLGIM, modified OLGA and modified OLGIM classifications led to downgrade of stages in comparison with the original OLGA classification (27%, 15% and 30% respectively).
- In all classification systems, dysplastic lesions clustered (86%) in high-risk stages.