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Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis
Author(s) -
Kaminishi Michio,
Yamaguchi Hirokazu,
Nomura Sachiyo,
Oohara Takeshi,
Sakai Shigeru,
Fukutomi Hisayuki,
Nakahara Akira,
Kashimura Hiromasa,
Oda Masaya,
Kitahora Tetsuji,
Ichikawa Hideyuki,
Yabana Tsuyosi,
Yagawa Yuichi,
Sugiyama Toshiro,
Itabashi Masayuki,
Unakami Masamitsu,
Oguro Yanao,
Sakita Takao
Publication year - 2002
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2002.00199.x
Subject(s) - medicine , gastritis , atrophic gastritis , gastroenterology , antrum , biopsy , helicobacter pylori , chronic gastritis , intestinal metaplasia , pathology , stomach
Background : Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods : One hundred and fifty‐five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results : Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion : Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated.