Abstract:ObjectiveTo investigate the predictive value of operative link on gastritis assessment (OLGA) and operative link on gastritis assessment based on intestinal metaplasia (OLGIM) on the risks of gastric cancer of patients with chronic atrophic gastritis. MethodsData of 643 patients were collected in the retrospective study, who were diagnosed with chronic atrophic gastritis or intestinal metaplasia by endoscopy and pathology in Shenzhen Hospital of Southern Medical University from July 2016 to November 2018. Standard gastroscopy was performed to assess the presence and extent of atrophy, and the severity of atrophy, intestinal metaplasia, and the presence of intraepithelial neoplasia were confirmed by pathologic diagnosis. Atrophy and intestinal metaplasia were graded according to OLGA and OLGIM systems, and the detection rate of high-grade intraepithelial neoplasia (HGIN) was compared in patients with different grades. ResultsThe detection rate of HGIN in patients with high OLGA grade (13.89%, 10/72) was significantly higher than that in patients with low OLGA grade (3.85%, 22/571, χ2=13.618, P<0.001). The detection rate of HGIN in patients with high OLGIM grade (13.41%, 11/82) was significantly higher than that in patients with low OLGIM grade (3.74%, 21/561, χ2=14.150, P<0.001). The detection rate of HGIN was further increased in patients with high grade in both OLGA and OLGIM systems [21.21% (7/33) VS 4.10% (25/610), χ2=19.389, P<0.001]. Compared with patients with low grade, the odds ratio of occurrence of HGIN in patients with high grade of OLGA and that with high grade of OLGIM were 2.640 (95%CI: 1.083-6.439, P=0.033) and 2.747 (95%CI: 1.156-6.528, P=0.022), respectively, and the odds ratio of patients with high grade in both OLGA and OLGIM was 6.300 (95%CI: 2.497-15.897, P<0.001). ConclusionOLGA and OLGIM systems have a remarkable predictive value for assessment of cancerization risk of chronic atrophic gastritis, and can be used as an important reference for patients to perform magnifying gastroscopy and to make follow-up strategies.