The effect of incisura angularis biopsy sampling on the assessment of gastritis stage

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

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Objectives: It is important to stratify patients according to the magnitude of risk for gastric cancer development; the OLGA (Operative Link for Gastritis Assessment) and OLGIM (Operative Link on Gastric Intestinal Metaplasia) staging systems of lesions in the stomach mucosa have been proposed for this purpose. There are some discrepancies in the current guidelines regarding the value of incisura angularis biopsies. The aim of our study was to assess the value of incisura angularis biopsy in staging gastritis according to the OLGA and OLGIM systems by examining the atrophic, metaplastic and inflammatory changes in the antrum, incisura angularis and corpus. Patients and Methods: We enrolled 835 patients undergoing upper endoscopy. Three expert gastrointestinal pathologists graded biopsy specimens according to the Sydney classification and the stage of gastritis was assessed by the OLGA and OLGIM systems. Results: The results demonstrated that severe atrophic, metaplastic and chronic inflammatory changes were more frequently observed in the incisura angularis mucosa than in the antrum or corpus mucosae (P<0.05). There was a general downgrading of stage by 18.0% for OLGA and by 4.0% for OLGIM when the incisura angularis was excluded from the staging. Furthermore, there was a 30-35% downgrading for high-risk OLGA/OLGIM stages. Conclusion: The incisura angularis undergoes more severe atrophic, metaplastic and chronic inflammatory changes than the antrum and corpus. Incisura angularis biopsies should be routinely included in the biopsy sampling protocol.

Original languageEnglish
Pages (from-to)510-513
Number of pages4
JournalEuropean Journal of Gastroenterology and Hepatology
Volume26
Issue number5
DOIs
Publication statusPublished - May 2014
Externally publishedYes

Keywords

  • atrophy
  • gastritis staging
  • incisura angularis
  • inflammation
  • Operative Link for Gastritis Assessment
  • Operative Link on Gastric Intestinal Metaplasia

Field of Science

  • 3.2 Clinical medicine

Publication Type

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

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