Gastritis and gastric cancer - Asia

The high prevalence of Helicobacter pylori infection in Japan is associated closely with high incidence of atrophic gastritis and gastric cancer. in relation with high incidence of gastric cancer, the accurate diagnosis of H. pylori infection and the assessment of the extent of atrophic gastritis are essentially mandatory. For this purpose, the biopsy should be taken at the sites specified according to the Kimura System, which was first proposed as the specification for biopsy sites at routine endoscopic gastric biopsy (Yokohama Recommendation 1996 by Kimura and Sipponen at the 10th Asian Pacific Congress of Gastroenterology). The following biopsy sites are recommended: sites 4 and 6 (mid-antrum and mid-body on the greater curvature, respectively) for the diagnosis of H. pylori, and sites 1, 3 (mid-antrum and mid-body on the lesser curvature, respectively), and 6 (mid-body on the greater curvature) for the assessment of the extent of atrophic gastritis. Four biopsies from the specified sites 1, 3, 4, and 6 are recommended conclusively as routine endoscopic gastric biopsy.