Gastrites auto-immunes : évaluation des systèmes OLGA et OLGIM
Mots-clés :
gastrite chronique - atrophie gastrique - métaplasie intestinale - classification.Résumé
Introduction : La gastrite auto-immune présente un risque de cancérisation en rapport avec l’atrophie et la métaplasie intestinale. Deux nouvelles classifications, OLGA (Operative Link on Gastritis Assessment) et OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) sont proposées afin d’individualiser les formes à haut risque évolutif (stades III et IV).
But: évaluer les classifications de OLGA et de OLGIM au cours des gastrites auto-immunes.
Méthodes : Etude descriptive moncentrique portant sur 30 cas de gastrites auto-immunes colligés sur quatre années. La réévaluation de l’atrophie et de la métaplasie intestinale, de l’antre et du corps gastrique, a permis de définir respectivement les stades OLGA et OLGIM.
Résultats : Nos gastrites auto-immunes étaient aux stades à haut risque dans 26,5% des cas selon les deux classifications. 95% des gastrites à faible risque selon OLGA présentaient une atrophie fundique modérée à sévère. Une association significative était notée entre les gastrites à haut risque selon OLGA et l’hyperplasie neuroendocrine. OLGA et OLGIM présentaient une corrélation positive et hautement significative entre elles avec une discordance évaluée à 2%.
Conclusions : Les classifications de OLGA et OLGIM dans les gastrites auto-immunes permettraient de sélectionner les formes de gastrites à haut risque nécessitant une surveillance étroite.
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Références
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