Staging and grading of chronic gastritis. Hum Pathol

Department of Oncological and Surgical Sciences, University of Padova, Italy.
Human Pathlogy (Impact Factor: 2.77). 04/2005; 36(3):228-33. DOI: 10.1016/j.humpath.2004.12.008
Source: PubMed


Chronic gastritis is an inflammatory condition of the gastric mucosa that may include structural alterations of the glandular compartment. The semiquantitative scoring systems advocated in the Sydney Systems and the subsequent Atrophy Club Guidelines remain essential for the recognition of the spectrum of the lesions detectable in gastric inflammatory disease. Most practicing pathologists, however, find them too cumbersome to use in their routine diagnostic activities. In this article, we propose a reporting system for chronic gastritis in staging and grading. Staging would convey information on the topography and extension of the gastric atrophic changes, whereas grading should represent the semiquantitative assessment of the combined severity of both mononuclear and granulocytic inflammation. This system could offer gastroenterologists a more immediate perception of the overall condition of the gastric mucosa while also providing useful information about gastric cancer risk.

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Available from: Robert M Genta, Feb 19, 2014
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    • "The first system of staging was put forward in 2005 by an international group of pathologists and gastroenterologists (OLGA acronym stands for 'Operative Link on Gastritis Assessment') [21]. According to the OLGA proposal the gastritis stage results by the combination of the atrophy scores as assessed in the distal stomach, with those assessed in the biopsy samples obtained from the proximal gastric mucosa [19]. The stage indicates the individual likelihood to develop malignant neoplasia, and the large majority the cancer cases are expected to develop in patients with stages III and IV [22]. "
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    ABSTRACT: Gastric cancer (GC) is the third leading cause of cancer-related death worldwide and it mostly develops in long-standing inflammatory conditions, and Helicobacter pylori-gastritis, in particular. Despite the increasing understanding of both the phenotypic alterations and the molecular mechanisms occurring during GC multi-step carcinogenesis, no reliable biomarker is available to be reliably implemented into GC secondary prevention strategies. Multidisciplinary diagnostic approaches integrating endoscopy, serology, histology and molecular profiling currently appears as the most appropriate approach for patients’ stratification into different GC risk classes.
    Full-text · Article · Dec 2014 · Baillière&#x027 s Best Practice and Research in Clinical Gastroenterology
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    • "For example, incomplete-type metaplasia has been reported to be significantly correlated with some topographic patterns of metaplasia associated with greater cancer risk.7 However, other studies refuted this idea8 and recommended the establishment of clear guidelines for follow-up or treatment of patients with IM.9 Recently, a new staging system for gastritis has been proposed to identify patients at the highest risk for gastric cancer.10,11 Furthermore, risk scores for clinical, histological, and serologic parameters which can predict the presence of extensive intragastric IM with increased risk of gastric cancer have also been proposed.12,13 "
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    ABSTRACT: Intestinal metaplasia (IM) is a premalignant condition. This study aimed to evaluate the correlation between endoscopic and histological findings of IM. The cases of IM were graded by conventional endoscopy, and biopsies were taken from the antrum and body of 1,333 subjects for histological IM diagnosis. Multivariate analyses were performed to identify the factors that affect the sensitivity of endoscopic IM diagnosis. The sensitivity/specificity of endoscopic IM diagnosis based on histology was 24.0%/91.9% for the antrum and 24.2%/88.0% for the body. As indicated by multivariate analysis, the presence of endoscopic atrophic gastritis (AG) (odds ratio [OR], 4.73; 95% confidence interval [CI], 2.07 to 10.79) and the activity of mucosal inflammation (OR, 2.21; 95% CI, 1.08 to 4.54) were associated with the sensitivity of endoscopic IM diagnosis in the antrum, while the presence of endoscopic AG (OR, 8.02; 95% CI, 4.55 to 14.15), dysplasia (OR, 2.40; 95% CI, 1.07 to 5.39), and benign gastric ulcers (OR, 0.35; 95% CI, 0.15 to 0.081) were associated with the sensitivity of endoscopic IM diagnosis in the body. As the sensitivity of endoscopic IM diagnosis was low, a high index of suspicion for IM is necessary in the presence of atrophy, and confirmation by histology is also necessary.
    Full-text · Article · Jan 2013 · Gut and liver
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    • "The host response to H. pylori and bacterial products is composed of T-and B-cell lymphocytes, denoting chronic gastritis, followed by the infiltration of the lamina propria and gastric epithelium by polymorphonuclear leucocytes that eventually phagocytize the bacteria. Gastric epithelial cells release proinflammatory cytokine interleukin (IL)-8 and express class II molecules, which increase inflammation (Nogueira et al. 2001; Rugge & Genta 2005). Johanna et al. (2003) reported that lymphocytic gastritis was commonly associated with H. pylori infection. "
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    ABSTRACT: Helicobacter pylori (H. pylori) is causally associated with peptic ulcer disease and gastric carcinoma. Typically, children get infected during the first decade of life, but diseases associated with H. pylori are seen mainly in adults. Multiple diagnostic methods are available for the detection of H. pylori infection. The aim of this study was to evaluate the correlation and diagnostic accuracy of three invasive methods [rapid urease test (RUT), histology and bacterial culture] and one non-invasive method (IgG serology) for diagnosis of H. pylori infection in a prospective cohort study conducted on 50 symptomatic children between two and eighteen years of age. Endoscopies with gastric biopsies were performed for RUT, culture and histopathological examination, respectively. IgG antibodies were measured in patient sera using a commercially available enzyme-linked immunosorbent assay (ELISA). RUT and positive H. pylori IgG antibodies were concordant in 88% (44/50) of patients. Both tests were negative in 32% (16/50), and both were positive in 56% (28/50). Disagreement occurred in 12% (6/50) of the patients: three of them (6%) had positive RUT and negative H. pylori IgG, and another three (6%) had negative RUT and positive H. pylori IgG. A combination of RUT with non-invasive serology constituted the optimum approach to the diagnosis of H. pylori infection in symptomatic children. The non-invasive serological test (ELISA) could not be used alone as the gold standard because it cannot distinguish between active and recently treated infection; and bacterial culture could not be used alone because of its low sensitivity.
    Full-text · Article · Aug 2012 · International Journal of Experimental Pathology
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