OLGA及OLGIM分期系统对1790例 慢性萎缩性胃炎患者胃癌风险的评估价值

Value of OLGA and OLGIM staging system in evaluating the risk of gastric cancer in 1790 patients with chronic atrophic gastritis

目的:探讨可操作的与胃癌风险联系的萎缩评估(OLGA)和可操作的与胃癌风险联系的肠化生评估(OLGIM)系统对慢性萎缩性胃炎(CAG)癌变风险的评估价值。方法:1790例CAG患者为研究对象,记录基本资料以及胃镜、病理、幽门螺杆菌(HP)检查结果,分析OLGA/OLGIM分期与胃黏膜病变的相关性,比较不同OLGA/OLGIM分期患者HP感染情况。结果:1790例CAG中,病理表现为萎缩908例(50.73%),肠化生1384例(77.32%),上皮内瘤变(含癌变)185例(10.34%);OLGA分期中,0期、Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期分别有882例、687例、170例、44例和7例;OLGIM分期中,0期、Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期分别有406例、1092例、221例、53例和18例。OLGA及OLGIM分期与胃黏膜病变均呈正相关(r s=0.096、0.138,均P<0.05)。OLGA及OLGIM各分期HP感染率比较总体差异均具有统计学意义(均P<0.05)。结论:OLGA及OLGIM分期系统对胃癌风险评估具有一定临床价值。

Objective:To explore the value of the OLGA and OLGIM staging system in evaluating the risk of chronic atrophic gastritis(CAG).Methods:1790 CAG patients were collected as the research objects.Their basic data and the results of gastroscopy,pathology and HP examination were recorded.The correlation between OLGA/OLGIM staging and gastric mucosal lesions was analyzed.HP infection in patients with different OLGA/OLGIM staging was compared.Results:Among 1790 cases of CAG,the pathological manifestations were 908 cases of atrophy(50.73%),1384 cases(77.32%)of intestinal metaplasia,and 185 cases(10.34%)of intraepithelial neoplasia(including carcinogenesis);in OLGA staging,there were 882 cases in stage 0,687 cases in stageⅠ,170 cases in stageⅡ,44 cases in stageⅢ,and 7 cases in stageⅣ;in OLGIM staging,there were 406 cases in stage 0,1092 cases in stageⅠ,221 cases in stageⅡ,53 cases in stageⅢ,and 18 cases in stageⅣ.OLGA and OLGIM staging were positively correlated with gastric mucosal lesions(r s=0.096,0.138,all P<0.05).The overall difference in HP infection rates between OLGA and OLGIM staging were statistically significant(all P<0.05).Conclusion:OLGA and OLGIM staging system has certain clinical value for gastric cancer risk assessment.