[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-346205-105":59,"doc-detail-346205-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","gastric-mucosa-cancer-risk-the-operative-link-on-gastritis-assessment-staging-system","Gastric Mucosa Cancer Risk: The Operative Link on Gastritis Assessment Staging System","","Gastric mucosal atrophy is presented as the key cancerization field in gastric cancer development, assessable through endoscopy and histology, with serology (pepsinogens and their ratio, gastrin) offering functional information. The article explains that serology’s individual-level clinical reliability remains controversial outside large epidemiologic studies. It details how the OLGA system classifies atrophy severity and topography into stages 0–IV, linking progression to stepwise cancer risk, and distinguishes low- (0–I) versus high-risk (III–IV) profiles while noting stage II controversy. It further discusses implications for endoscopy/histology surveillance and interval, patient-specific non-invasive monitoring.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/gastric-mucosa-cancer-risk-the-operative-link-on-gastritis-assessment-staging-system/346205/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/gastric-mucosa-cancer-risk-the-operative-link-on-gastritis-assessment-staging-system/346205.png","ImageObject",300,407,{"name":92,"@type":93},"Ophelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is gastric mucosal atrophy considered central to gastric cancer risk?","Question",{"text":112,"@type":113},"Atrophic changes in the gastric mucosa are described as the cancerization field for gastric cancer development and can be assessed endoscopically and histologically.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the OLGA staging system classify cancer risk?",{"text":117,"@type":113},"OLGA classifies the severity and topography of mucosal atrophy into five stages (0 to IV), with international trials validating stepwise increases in cancer risk across progression.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the role of gastric serology at the index endoscopy?",{"text":121,"@type":113},"Serology may help overcome population-based inconsistencies, and patient-specific serology could support interval, non-invasive monitoring within an endoscopy/histology follow-up framework.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},346205,1790339626,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","KJHUGR REVIEW  \npISSN 1738-3331 / eISSN 2671-826X [https://doi.org/10.7704/kjhugr.2026.0027](https://doi.org/10.7704/kjhugr.2026.0027) Korean J Helicobacter Up Gastrointest Res 2026;26(3):265-274  \n[https://www.helicojournal.org](https://www.helicojournal.org)  \nReceived  \nRevised Accepted  \nMarch 31, 2026  \nMay 6, 2026  \nMay 19, 2026  \nCorresponding author  \nMassimo Rugge, MD, FACG Department of Medicine-DIMED,  \nAnatomic Pathology and Cytopathology Unit, University of Padova Italy, Via Aristide Gabelli, 61, Padova 35121, Italy [E-mail: massimo.rugge@unipd.it](E-mail: massimo.rugge@unipd.it)  \nAvailability of Data and Material  \nData sharing not applicable to this article as no datasets were generated or analyzed during the study.  \nConflicts of Interest  \nMassimo Rugge, a contributing editor of the Korean Journal of Helicobacter and Upper Gastrointestinal Research, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.  \nFunding Statement  \nNone  \nAcknowledgements  \nNone  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/l](https://creativecommons.org/l)icenses/ by-nc/4 .0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nGastric Mucosa Cancer Risk: The Operative Link on Gastritis Assessment Staging System  \nMassimo Rugge1,2, Marta Sbaraglia1, Giulia Fiorini3,4, Gavino Faa5,6, and Robert M Genta2,7  \n1Department of Medicine-DIMED, Anatomic Pathology and Cytopathology Unit, University of Padova Italy, Padova, Italy  \n2Departments of Pathology and Medicine, Baylor College of Medicine, Houston, TX, USA 3Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy 4Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 5Department of Medical Sciences and Public Health, University of Cagliari and AOU of Cagliari, Cagliari, Italy  \n6Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA 7Unilabs Pathologie, Geneva, Switzerland  \nGastric mucosa atrophy is the cancerization field for gastric cancer development. Atrophic changes in the gastric mucosa can be assessed endoscopically and histologically. Gastric serology (e.g., pepsinogens and their ratio, and gastrin) may provide information on the functional status of the mucosa. However, outside large-scale epidemiological studies, the clinical reliability of serology atthe individual patient level remains controversial. Histology-based estimates of atrophy-associated neoplastic risk require mucosal specimens from both the antral/mucus-secreting and corpus/ fundus oxyntic compartments. Inspired by the clinical–biological framework of cancer staging, the Operative Link on Gastritis Assessment (OLGA) staging system classifies the severity and topography of mucosal atrophy into five stages, ranging from 0 to IV. International trials have validated the stepwise increasing risk of cancer with disease progression. Based on this evidence, OLGA stages are classified into low-risk (0–I) and high-risk (III–IV), with stage II remaining clinically controversial. The prevalence of high-risk stages varies according to patient-and populationspecific risk factors. Among these, the most significant is the prevalence of Helicobacter pylori, a recognized oncogenic agent. Bacterial infection at the time of the initial endoscopy requires eradication therapy regardless of the stage of gastritis. Histological stage reliably identifies the endoscopic population at a high risk of cancer progression and shapes the schedule of endoscopy/histology-based surveillance. Serology at the index endoscopy may circumvent the inherent inconsistencies of population-based studies. This patient-specific serology could serve as an interval for ","cbCaibiB36KGqu5B","https://ap.wps.com/l/cbCaibiB36KGqu5B","pdf",469752,"English","# Introduction\n## Gastritis definitions and clinical presentation\n## Gastric serology and biomarker rationale\n## Helicobacter pylori and autoimmune gastritis diagnostics","[{\"question\":\"Why is gastric mucosal atrophy considered central to gastric cancer risk?\",\"answer\":\"Atrophic changes in the gastric mucosa are described as the cancerization field for gastric cancer development and can be assessed endoscopically and histologically.\"},{\"question\":\"How does the OLGA staging system classify cancer risk?\",\"answer\":\"OLGA classifies the severity and topography of mucosal atrophy into five stages (0 to IV), with international trials validating stepwise increases in cancer risk across progression.\"},{\"question\":\"What is the role of gastric serology at the index endoscopy?\",\"answer\":\"Serology may help overcome population-based inconsistencies, and patient-specific serology could support interval, non-invasive monitoring within an endoscopy/histology follow-up framework.\"}]","Gastric Mucosa Cancer Risk: The Operative Link on Gastritis Assessment Staging System | PDF",1790060457,25]