Risk Management and Healthcare Policy (Nov 2022)
Helicobacter pylori Infection Combined with OLGA and OLGIM Staging Systems for Risk Assessment of Gastric Cancer: A Retrospective Study in Eastern China
Abstract
Min Wu,1 Shuo Feng,1 Meng Qian,2 Song Wang,3 Kaiguang Zhang1 1Department of Gastroenterology, Affiliated Provincial Hospital, Anhui Medical University, Anhui, People’s Republic of China; 2Graduate School of Bengbu Medical College, Anhui, People’s Republic of China; 3Department of Gastroenterology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, People’s Republic of ChinaCorrespondence: Kaiguang Zhang, Department of Gastroenterology, Affiliated Provincial Hospital, Anhui Medical University, Anhui, People’s Republic of China, Email [email protected] Song Wang, Department of Gastroenterology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui, People’s Republic of China, Email [email protected]: Helicobacter pylori (H. pylori) infection is a high-risk factor for gastric cancer (GC). The main aim of this study was to evaluate the effect of H. pylori on gastritis staging systems and the value of H. pylori combined with gastritis staging systems in predicting GC risk.Patients and Methods: This study enrolled 609 patients with gastric atrophy (GA) and 527 patients with gastric intestinal metaplasia (GIM), who were graded by the OLGA and OLGIM staging systems, respectively. Each individual underwent serum pepsinogen (PG) test, H. pylori detection and questionnaire investigation. We did a real-world retrospective follow-up survey for them in April 2022.Results: Compared with H. pylori-negative patients, H. pylori-positive patients had higher serum PGs/gastrin-17 (G-17) levels and lower PGR levels, regardless of OLGA/OLGIM stages I–II or III–IV. Furthermore, eight patients with atrophic gastritis who progressed to GC were previously in OLGA stages III–IV and OLGIM stages II–IV. The average duration of this process was 2.19± 1.03 years. Logistic regression analysis indicated that PGI and H. pylori infection were independent risk factors of individuals with OLGA stages III–IV. Age and PGR were independent risk factors of patients with OLGIM stages III–IV. PGI and PGR had good clinical diagnostic values for OLGA stages III–IV and OLGIM stages III–IV, respectively.Conclusion: Patients with OLGA/OLGIM stages III–IV should undergo endoscopic surveillance regardless of H. pylori infection. H. pylori-positive patients with OLGIM stage II also have a high risk of GC. H. pylori combined with PGI and PGR is helpful to evaluate the severity of chronic gastritis.Keywords: atrophy, metaplasia, Helicobacter pylori, gastric cancer, risk factors
