Autoimmune gastritis: Histology phenotype and OLGA staging

M. Rugge, M. Fassan, M. Pizzi, V. Zorzetto, G. Maddalo, S. Realdon, M. De Bernard, C. Betterle, R. Cappellesso, G. Pennelli, M. De Boni, F. Farinati

Research output: Contribution to journalArticle

Abstract

Background Among Western populations, the declining incidence of Helicobacter pylori infection coincides with a growing clinical impact of autoimmune gastritis. Aims To describe the histological phenotype of autoimmune gastritis, also to test the prognostic impact of OLGA staging in the autoimmune setting. Methods 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. Results 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%)]. Conclusions 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.

Original languageEnglish
Pages (from-to)1460-1466
Number of pages7
JournalAlimentary Pharmacology and Therapeutics
Volume35
Issue number12
DOIs
Publication statusPublished - Jun 2012

ASJC Scopus subject areas

  • Pharmacology (medical)

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    Rugge, M., Fassan, M., Pizzi, M., Zorzetto, V., Maddalo, G., Realdon, S., De Bernard, M., Betterle, C., Cappellesso, R., Pennelli, G., De Boni, M., & Farinati, F. (2012). Autoimmune gastritis: Histology phenotype and OLGA staging. Alimentary Pharmacology and Therapeutics, 35(12), 1460-1466. https://doi.org/10.1111/j.1365-2036.2012.05101.x