The first two authors contributed equally.
Autoimmune gastritis: histology phenotype and OLGA staging
Article first published online: 22 APR 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 35, Issue 12, pages 1460–1466, June 2012
How to Cite
Rugge, M., Fassan, M., Pizzi, M., Zorzetto, V., Maddalo, G., Realdon, S., De Bernard, M., Betterle, C., Cappellesso, R., Pennelli, G., de Boni, M. and Farinati, F. (2012), Autoimmune gastritis: histology phenotype and OLGA staging. Alimentary Pharmacology & Therapeutics, 35: 1460–1466. doi: 10.1111/j.1365-2036.2012.05101.x
- Issue published online: 14 MAY 2012
- Article first published online: 22 APR 2012
- Manuscript Accepted: 28 MAR 2012
- Manuscript Revised: 27 MAR 2012
- Manuscript Revised: 14 MAR 2012
- Manuscript Received: 27 FEB 2012
- Guido Berlucchi” Foundation
- Morgagni” Association for Oncological Research
Among Western populations, the declining incidence of Helicobacter pylori infection coincides with a growing clinical impact of autoimmune gastritis.
To describe the histological phenotype of autoimmune gastritis, also to test the prognostic impact of OLGA staging in the autoimmune setting.
A single-institutional series (spanning the years 2003–2011) of 562 consecutive patients (M:F ratio: 1:3.7; mean age = 57.6 ± 14.4 years) with serologically confirmed autoimmune gastritis underwent histology review and OLGA staging.
Helicobacter pylori infection was ascertained histologically in 44/562 cases (7.8%). Forty six biopsy sets (8.2%) featured OLGA stages III–IV; they included all four cases of incidental epithelial neoplasia (three intraepithelial and one invasive; three of these four cases had concomitant H. pylori infection). There were 230 (40.9%) and 139 (24.7%) cases, respectively, of linear and micro-nodular enterochromaffin-like cell hyperplasia; 19 (3.4%) type I carcinoids were detected. The series included 116 patients who underwent repeated endoscopy/biopsy sampling (mean time elapsing between the two procedures = 54 months; range 24–108). Paired histology showed a significant (P = 0.009) trend towards a stage progression [the stage increased in 25/116 cases (22%); it remained unchanged in 87/116 cases (75%)].
In autoimmune gastritis, the cancer risk is restricted to high-risk gastritis stages (III–IV), and is associated mainly with concomitant H. pylori infection. OLGA staging consistently depicts the time-dependent organic progression of the autoimmune disease and provides key information for secondary gastric cancer prevention strategies.