Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication

BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk; however, the score in the patients with primary gastric cancer afterHelicobacter pylori(H. pylori) eradication therapy is unknown. AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed afterH. pylorieradication. METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer afterH. pylorieradication. The score was compared between single gastric cancer group and multiple gastric cancers group. RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer afterH. pylorieradication was 4.0 points in average. The score was 3.8 points in the single gastric cancer group, and 5.1 points in the multiple gastric cancers group. The multiple group had a significantly higher score than the single group (P= 0.016). In the multiple gastric cancers group, all the patients (7/7) had 5 or higher Kyoto score, while in single gastric cancer group, the proportion of patients with a score of 5 or higher was less than half, or 44.7% (17/38). CONCLUSION Patients diagnosed with gastric cancer afterH. pylorieradication tended to have advanced gastritis. In particular, in cases of multiple gastric cancers developed afterH. pylorieradication, the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus.