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Helicobacter. 2018 Dec;23(6):e12542. doi: 10.1111/hel.12542. Epub 2018 Oct 10.

Usefulness of OLGA and OLGIM system not only for intestinal type but also for diffuse type of gastric cancer, and no interaction among the gastric cancer risk factors.

Yun CY1, Kim N1,2,3, Lee J4, Lee JY1,5, Hwang YJ1, Lee HS6, Yoon H1,3, Shin CM1,3, Park YS1,3, Kim JW1, Lee DH1,2,3.

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Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University Seoul, South Korea.
Tumor Microenvironment Global Core Research Center, Seoul National University Seoul, South Korea.
Division of Statistics in Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
Departments of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea.



The operative link on gastric atrophy (OLGA) and operative link on gastric intestinal metaplasia (OLGIM) stages have been suggested for risk estimation of gastric cancer (GC). However, usefulness of OLGA/OLGIM systems in diffuse type of GC was not investigated so far. The aims of this study were to evaluate the OLGA/OLGIM systems in estimating the GC risk according to Lauren's classification and to investigate the interaction among the risk factors.


The OLGA/OLGIM stages were evaluated in 1398 (765 control and 633 GC patients) who were prospectively enrolled in the Seoul National University Bundang Hospital. Synergistic interaction among the risk factors for GC was calculated using an additive model.


Among 387 intestinal-type GC patients, 71 (18.3%) were high-risk OLGA stages (III, IV) and 113 (29.2%) were high-risk OLGIM stages (III, IV). Of the 246 patients with diffuse-type GC, 36 (14.6%) were high-risk OLGA stages and 39 (15.9%) were high-risk OLGIM stages. Multivariable analysis revealed family history of GC, Helicobacter pylori infection, high-risk OLGA stages, and high-risk OLGIM stages as independent risk factors for GC regardless of histologic type (odds ratios [ORs] 1.78, 1.94, 2.63, and 3.18, respectively). There was no significant risk modification among the H. pylori infection, family history of GC, and high-risk OLGA/OLGIM stages.


High-risk OLGA/OLGIM stages are important prediction markers for GC regardless of H. pylori infection or family history of GC not only for the intestinal type but also for diffuse-type GC.


Gastritis; Helicobacter pylori; Metaplasia; Stomach neoplasms

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