Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis

被引:10
作者
Toyoshima, Osamu [1 ,3 ]
Nishizawa, Toshihiro [1 ,2 ]
机构
[1] Toyoshima Endoscopy Clin, Dept Gastroenterol, Tokyo 1570066, Japan
[2] Int Univ Med & Welf, Dept Gastroenterol & Hepatol, Narita 2868520, Japan
[3] Toyoshima Endoscopy Clin, Dept Gastroenterol, Seijo 6 17 5, Setagaya Ku, Tokyo 1570066, Japan
关键词
Kyoto classification; Gastritis; Endoscopy; Gastric cancer; Histology; Helicobacter pylori; HELICOBACTER-PYLORI ERADICATION; INTESTINAL METAPLASIA; REGULAR ARRANGEMENT; COLLECTING VENULES; CANCER DEVELOPMENT; NODULAR GASTRITIS; RISK; ASSOCIATION; RESECTION; ATROPHY;
D O I
10.3748/wjg.v28.i43.6078
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
This editorial provides an update of the recent evidence on the endoscopy-based Kyoto classification of gastritis, clarifying the shortcomings of the Kyoto classification, and providing prospects for future research, with particular focus on the histological subtypes of gastric cancer (GC) and Helicobacter pylori (H. pylori) infection status. The total Kyoto score is designed to express GC risk on a score ranging from 0 to 8, based on the following five endoscopic findings: Atrophy, intestinal metaplasia (IM), enlarged folds (EF), nodularity, and diffuse redness (DR). The total Kyoto score reflects H. pylori status as follows: 0, >= 2, and >= 4 indicate a normal stomach, H. pylori-infected gastritis, and gastritis at risk for GC, respectively. Regular arrangement of collecting venules (RAC) predicts non-infection; EF, nodularity, and DR predict current infection; map-like redness (MLR) predicts past infection; and atrophy and IM predict current or past infection. Atrophy, IM, and EF all increase the incidence of H. pylori-infected GC. MLR is a specific risk factor for H. pylori-eradicated GC, while RAC results in less GC. Diffuse-type GC can be induced by active inflammation, which presents as EF, nodularity, and atrophy on endoscopy, as well as neutrophil and mononuclear cell infiltration on histology. In contrast, intestinal-type GC develops via atrophy and IM, and is consistent between endoscopy and histology. However, this GC risk-scoring design needs to be improved.
引用
收藏
页码:6078 / 6089
页数:12
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