Gastric biopsy with Sydney grading system (OLGA)

Biopsy according to the OLGA system (Operative Link for Gastritis Assessment) — is the most modern and standardized method of pathomorphological examination of the gastric mucosa. Unlike a conventional biopsy, this method involves taking samples from five specific points in the stomach for a comprehensive assessment of the degree of inflammation and the stage of atrophy of the mucosa.

Research objective: The main task of the OLGA system is to determine cancer risk for the patient. The study allows not only to determine the presence of gastritis, but also to mathematically calculate the probability of developing stomach cancer in the future, based on the severity of atrophic changes.

What does the pathologist evaluate:

• Degree of inflammation (Activity): intensity of infiltration of the mucous membrane by immune system cells (neutrophils, lymphocytes).

• Stage of atrophy (Atrophy): the percentage of loss of normal gastric glands and their replacement by connective tissue or intestinal epithelium.

• Localization of changes: The analysis is performed separately for the antrum (3 biopsies) and the body of the stomach (2 biopsies).

• Presence of Helicobacter pylori: mandatory search for the bacteria that provokes the development of atrophy.

Clinical significance: Based on the results of the study, the patient is assigned a score from 0 to IV.

• Stages 0, I, II are considered prognostically favorable.

• Stages III and IV indicate a high risk of developing stomach cancer. This approach allows the gastroenterologist to form a clear schedule of follow-up visits: from one examination every 5 years to an annual targeted gastroscopy.

When is it prescribed:

• long-term chronic gastritis with suspected atrophy;

• having first-degree relatives who had stomach cancer;

• monitoring the condition of the mucosa after successful eradication (destruction) H. pylori;

• detection of areas of intestinal metaplasia during endoscopy.