07. Hepatitis‐71

Abstract

Background and aims OLGA high-stage gastritis has proved its role on identifying a subgroup of patients with higher risk of gastric cancer. Even in high-risk populations, however, this proportion is very low and taking routine mapped biopsies could be a burden. This study aims (1) to evaluate the role of moderate-to-severe endoscopic gastric atrophy (EGA) on predicting OLGA gastritis stage and (2) to assess the association of highstage OLGA gastritis with gastric neoplasia in Vietnamese population. Materials and methods A prospective cross-sectional study was conducted on 280 dyspeptic outpatients. EGA was assessed according to Kimura-Takemoto classification. Histological gastric atrophy was assessed according to internationally validated criteria and gastritis stage was established according to the OLGA staging system. Gastric neoplasia was assessed based on the Vienna classification. The pathologists who read the specimens were kept blind to the endoscopic results. Results The mean age of patients was 46.1 [range 20-78 years] with a male-to-female ratio of 1:1. High-stage gastritis (e.g. stage III or IV) was confirmed in 13 (4.6%) patients; who were all more than 40-year-old (p = 0.01), had H. pylori infection (p = 0.0006) and EGA (p < 0.001). Low grade dysplasia was found in 7 patients: 4/13 (30.7%) with high-stage gastritis versus 3/267 (1.1%) with low-stage gastritis (p < 0.0001). 6 of these 7 patients had EGA (p = 0.048). The sensitivity, specificity, positive predictive value and negative predictive value of EGA in high-stage gastritis diagnosis were 100%, 57.7%, 10.3% and 100% respectively. Conclusions OLGA high-stage gastritis was associated with gastric dysplasia and mostly diagnosed in patients with EGA. The absence of this endoscopic finding could effectively rule out the possibility of having high-stage gastritis.Aim To evaluate the association between moderate-to-severe endoscopic gastric atrophy finding (EGA) with the characteristics of intestinal metaplasia (IM). Method A cross-sectional study was conducted on 280 patients with endoscopic gastritis according to the Sydney system. EGA was evaluated according to the Kimura-Takemoto classification. Mapped biopsies were taken according to the revised Sydney system. Histochemical staining was performed for IM subtyping using PAS and Alcian blue 2.5. The pathologists who read the specimens were kept blind to the endoscopic results. ResultsThe mean age was 46.1 ± 10.5. The rate of IM was 28.9%. Incomplete IM subtype accounted for 29.6% and related to extensive IM (p = 0.01, OR = 3.9). Extensive IM with ≥3 bioptic sites accounted for 6.8% and was only found in the subgroup with EAG (p < 0.001). There were a significant association between EAG and IM (p < 0.001, OR = 15), incomplete IM subtype (p < 0.001, OR = 25.1) as well as extensive IM (p < 0.001, OR = 28.7). The sensitivity, specificity, positive predictive value and negative predictive value of this endoscopic finding in diagnosis of IM were: 86.4%, 71.9%, 55.6%, 92.9%; in diagnosis of incomplete IM ...