We read with great interest the article by Lee et al 1 evaluating the risk of progression from chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) to high-grade dysplasia (HGD) or gastric adenocarcinoma (GA), according to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) staging system. Patients with OLGIM III–IV had a substantially increased risk of HGD/GA, with a median time to progression of 22.7 months, while patients with OLGIM II had an intermediate risk. These findings complement the results by Rugge et al, 2 demonstrating a higher risk of neoplastic progression among patients with Operative Link on Gastritis Assessment (OLGA) III–IV, but not OLGA II. Studies directly comparing the predictive value of both OLGA and OLGIM systems in the same cohort are scarce.3 4 We leveraged the ‘Endoscopic Cohort and Histological OLGA staging’ (trial: NCT05969444) to compare the predictive capability of OLGA versus OLGIM for HGD/GA. We included 685 Chilean adults who underwent an oesophagogastroduodenoscopy with gastric mapping biopsies, and who subsequently had at least one endoscopic surveillance examination with mapping biopsies completed at least 6 months apart (table 1). The primary outcome was histologically confirmed incident HGD or GA according to baseline OLGA and OLGIM stages (assessed by two experienced pathologists). The kappa values for interpathologist and intrapathologist agreement were 0.63 and 0.71 for …

中文翻译：

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OLGA 和 OLGIM 作为拉丁美洲人群胃癌预测因子的比较：ECHOS 研究


我们饶有兴趣地阅读了 Lee 等人的文章 1，根据 Operative Link，评估了慢性萎缩性胃炎 (CAG) 伴肠化生 (IM) 进展为高度不典型增生 (HGD) 或胃腺癌 (GA) 的风险胃肠化生（OLGIM）分期系统。 OLGIM III-IV 患者发生 HGD/GA 的风险显着增加，中位进展时间为 22.7 个月，而 OLGIM II 患者的风险为中等。这些发现补充了 Rugge 等人的结果，2 表明胃炎评估手术链接 (OLGA) III-IV 级患者肿瘤进展的风险较高，但 OLGA II 级患者则不然。直接比较同一队列中 OLGA 和 OLGIM 系统预测价值的研究很少。3 4 我们利用“内镜队列和组织学 OLGA 分期”（试验：NCT05969444）来比较 OLGA 与 OLGIM 对 HGD/GA 的预测能力。我们纳入了 685 名智利成年人，他们接受了食管胃十二指肠镜检查和胃标测活检，随后至少间隔 6 个月完成了一次内镜监测检查和标测活检（表 1）。主要结局是根据基线 OLGA 和 OLGIM 分期（由两名经验丰富的病理学家评估）经组织学证实的 HGD 或 GA 事件。病理学家间和病理学家内一致性的 kappa 值分别为 0.63 和 0.71……