Top

Published in:

01-04-2014 | Original Article

Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems

Authors: Sergejs Isajevs, Inta Liepniece-Karele, Dainius Janciauskas, Georgijs Moisejevs, Viesturs Putnins, Konrads Funka, Ilze Kikuste, Aigars Vanags, Ivars Tolmanis, Marcis Leja

Published in: Virchows Archiv | Issue 4/2014

Abstract

Atrophic gastritis remains a difficult histopathological diagnosis with low interobserver agreement. The aim of our study was to compare gastritis staging and interobserver agreement between general and expert gastrointestinal (GI) pathologists using Operative Link for Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia (OLGIM). We enrolled 835 patients undergoing upper endoscopy in the study. Two general and two expert gastrointestinal pathologists graded biopsy specimens according to the Sydney classification, and the stage of gastritis was assessed by OLGA and OLGIM system. Using OLGA, 280 (33.4 %) patients had gastritis (stage I–IV), whereas with OLGIM this was 167 (19.9 %). OLGA stage III– IV gastritis was observed in 25 patients, whereas by OLGIM stage III–IV was found in 23 patients. Interobserver agreement between expert GI pathologists for atrophy in the antrum, incisura angularis, and corpus was moderate (kappa = 0.53, 0.57 and 0.41, respectively, p < 0.0001), but almost perfect for intestinal metaplasia (kappa = 0.82, 0.80 and 0.81, respectively, p < 0.0001). However, interobserver agreement between general pathologists was poor for atrophy, but moderate for intestinal metaplasia. OLGIM staging provided the highest interobserver agreement, but a substantial proportion of potentially high-risk individuals would be missed if only OLGIM staging is applied. Therefore, we recommend to use a combination of OLGA and OLGIM for staging of chronic gastritis.

Rugge M, Pennelli G, Pilozzi E, Fassan M, Ingravallo G, Russo VM et al (2011) Gastritis: the histology report. Dig Liv Dis 43:S373–S384CrossRef

Rugge M, de Boni M, Pennelli G, de Bona M, Giacomelli L, Fassan M et al (2010) Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study. Aliment Pharmacol Ther 31(10):1104–1111PubMed

Dinis-Ribeiro M, Areia M, de Vries AC, Marcos-Pinto R, Monteiro-Soares M, O’Connor A et al (2012) Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy 44(1):74–94PubMedCentralPubMedCrossRef

Dai YC, Tang ZP, Zhang YL (2011) How to assess the severity of atrophic gastritis. World J Gastroenterol 17(13):1690–1693PubMedCentralPubMedCrossRef

Bornschein J, Selgrad M, Wex T, Kuester D, Malfertheiner P (2012). Prevalence of atrophic gastritis in dyspeptic patients in Piedmont. A survey using the GastroPanel test. BMC Gastroenterol 12:10

Rugge M, Fassan M, Pizzi M, Farinati F, Sturniolo GC, Plebani M, Graham DY (2011) Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment. World J Gastroenterol 17(41):4596–4601PubMedCentralPubMedCrossRef

Rugge M, Genta RM, OLGA Group (2005) Staging gastritis: an international proposal. Gastroenterology 129(5):1807–1808CrossRef

Rugge M, Meggio A, Pennelli G, Piscioli F, Giacomelli L, De Pretis G, Graham DY (2007) Gastritis staging in clinical practice: the OLGA staging system. Gut 56(5):631–636PubMedCentralPubMedCrossRef

Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K et al (2008) OLGA staging for gastritis: a tutorial. Dig Liver Dis 40:650–658PubMedCrossRef

10.

El-Zimaity HM, Graham DY, Al-Assi MT, Malaty H, Karttunen TJ, Graham DP et al (1996) Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum Pathol 27:35–41PubMedCrossRef

11.

Offerhaus GJ, Price AB, Haot J, ten Kate FJ, Sipponen P, Fiocca R et al (1999) Observer agreement on the grading of gastric atrophy. Histopathology 34:320–325PubMedCrossRef

12.

Guarner J, Herrera-Goepfert R, Mohar A, Sanchez L, Halperin D, Ley C, Parsonnet J (1999) Interobserver variability in application of the revised Sydney classification for gastritis. Hum Pathol 30:1431–1444PubMedCrossRef

13.

Rugge M (2003) Atrophic gastritis: pathology and endoscopy in the reversibility assessment. Gut 52:1387–1388PubMedCentralPubMedCrossRef

14.

Kononov AV, Mozgovoi SI, Shimanskaia MV, Markelova MV, Osintseva IL, Vaskina TV, Paniushkin LV (2011) The Russian revision of chronic gastritis classification: reproducibility of the pathomorphologic Picture. Arkh Patol 73(4):52–56PubMed

15.

Leja M, Funka K, Janciauskas D, Putnins V, Ruskule A, Kikuste I et al (2013) Interobserver variation in assessment of gastric premalignant lesions: higher agreement for intestinal metaplasia than for atrophy. Eur J Gastroenterol Hepatol 25(6):694–699PubMedCrossRef

16.

Chen XY, van der Hulst RW, Bruno MJ, van der Ende A, Xiao SD, Tytgat GN et al (1999) Interobserver variation in the histopathological scoring of Helicobacter pylori related gastritis. J Clin Pathol 52:612–615PubMedCentralPubMedCrossRef

17.

Capelle LG, de Vries AC, Haringsma J, Ter Borg F, de Vries RA, Bruno MJ et al (2010) The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc 71:1150–1158PubMedCrossRef

18.

Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM (2000) The Vienna classification of gastrointestinal epithelial neoplasia. Gut 47(2):251–255PubMedCentralPubMedCrossRef

19.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef

20.

Nam KT, Lee HJ, Sousa JF, Weis VG, O’Neal RL, Finke PE et al (2010) Mature chief cells are cryptic progenitors for metaplasia in the stomach. Gastroenterology 139:2028–2037PubMedCentralPubMedCrossRef

21.

Cassaro M, Rugge M, Gutierrez O, Leandro G, Graham DY, Genta RM (2000) Topographic patterns of intestinal metaplasia and gastric cancer. Am J Gastroenterol 95:1431–1438PubMedCrossRef

22.

Marcos-Pinto R, Carneiro F, Dinis-Ribeiro M, Wen X, Lopes C, Figueiredo C et al (2012) First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia. Aliment Pharmacol Ther 35(12):1451–1459PubMedCrossRef

23.

Satoh K, Osawa H, Yoshizawa M, Nakano H, Hirasawa T, Kihira K, Sugano K (2008) Assessment of atrophic gastritis using the OLGA system. Helicobacter 13(3):225–229PubMedCrossRef

24.

Rugge M, Russo V, Busatto G, Genta RM, Di Mario F, Farinati F, Graham DY (2001) The phenotype of gastric mucosa coexisting with Barrett’s oesophagus. J Clin Pathol 54(6):456–460PubMedCentralPubMedCrossRef

Title: Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems
Authors: Sergejs Isajevs
Inta Liepniece-Karele
Dainius Janciauskas
Georgijs Moisejevs
Viesturs Putnins
Konrads Funka
Ilze Kikuste
Aigars Vanags
Ivars Tolmanis
Marcis Leja
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: Virchows Archiv / Issue 4/2014
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-014-1544-3

ACC 2024 Congress

Springer Medicine

Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2014

Lipomatous tumors of the anterior mediastinum with muscle differentiation: a clinicopathological and immunohistochemical study of three cases

Multilayered epithelium at the gastroesophageal junction is a marker of gastroesophageal reflux disease: data from a prospective Central European multicenter study (histoGERD trial)

Clinicopathological and prognostic significance of EZH2 expression in upper urinary tract carcinoma

Reproducibility of histopathologic tumor grading in penile cancer—results of a European project

In pulmonary lymphangioleiomyomatosis expression of progesterone receptor is frequently higher than that of estrogen receptor

High GOLPH3 expression is associated with a more aggressive behavior of epithelial ovarian carcinoma