High-risk individuals for gastric cancer would be missed for surveillance without subtyping of intestinal metaplasia

Sergejs Isajevs (Coresponding Author), Selga Savcenko, Inta Liepniece-Karele, Maria Blanca Piazuelo, Ilze Kikuste, Ivars Tolmanis, Aigars Vanags, Indra Gulbe, Linda Mezmale, Darhan Samentaev, Altynbek Tazedinov, Ramis Samsutdinov, Tatjana Belihina, Nurbek Igissinov, Marcis Leja

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


The use of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Assessment based on Intestinal Metaplasia (OLGIM) staging system is recommended for identifying subjects at risk for developing gastric cancer; usually high-risk lesions are considered only as stages III and IV. Accumulating evidence suggests that incomplete intestinal metaplasia (IM) is important in the development of gastric cancer. Our aim has been to identify the prevalence of incomplete IM in patients with low-risk OLGA/OLGIM stages among a high-risk general population. Healthy adult volunteers aged 40–64 years were invited to undergo upper endoscopy within a regional GISTAR pilot study in Kazakhstan (n = 166). Gastric lesions were staged according to OLGA/OLGIM staging system. High iron diamine–alcian blue (HID-AB) was used for subtyping IM. IM prevalence overall was 45.8%. Incomplete IM was present in 52.6% (type II in 30.3% and type III in 22.3%), whereas complete IM was found in 47.4% individuals. The prevalence of OLGIM I and II stage were 39.8 and 4.8%, respectively, whereas OLGIM III was observed in 1.2%. The prevalence of incomplete IM in patients stratified to OLGIM I was 54.5% (type II in 31.8% and type III in 22.7%). High prevalence of incomplete IM was detected not only in subjects with extensive IM, but in those stratified as at the OLGIM I stage. Without IM subtyping, patients with high risk of gastric cancer development would be missed for surveillance.

Original languageEnglish
Pages (from-to)679-686
Number of pages8
JournalVirchows Archiv
Issue number4
Publication statusPublished - Oct 2021
Externally publishedYes


  • Gastric cancer
  • OLGA
  • OLGIM intestinal metaplasia
  • Risk stratification
  • Subtypes

Field of Science*

  • 3.2 Clinical medicine
  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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