Consistency between the endoscopic Kyoto classification and pathological updated Sydney system for gastritis: A cross‐sectional study

Background Two methods are used to evaluate gastritis: the updated Sydney system (USS) with pathology and Kyoto classification, a new endoscopy‐based diagnostic criterion for which evidence is accumulating. However, the consistency of their results is unclear. This study investigated the consistency...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of gastroenterology and hepatology 2022-02, Vol.37 (2), p.291-300
Hauptverfasser: Toyoshima, Osamu, Nishizawa, Toshihiro, Yoshida, Shuntaro, Matsuno, Tatsuya, Odawara, Nariaki, Toyoshima, Akira, Sakitani, Kosuke, Watanabe, Hidenobu, Fujishiro, Mitsuhiro, Suzuki, Hidekazu
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Background Two methods are used to evaluate gastritis: the updated Sydney system (USS) with pathology and Kyoto classification, a new endoscopy‐based diagnostic criterion for which evidence is accumulating. However, the consistency of their results is unclear. This study investigated the consistency of their results. Methods Patients who underwent esophagogastroduodenoscopy and were evaluated for Helicobacter pylori infection for the first time were eligible. The association between corpus and antral USS scores (neutrophil activity, chronic inflammation, atrophy, and intestinal metaplasia) and Kyoto classification scores (atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) was assessed. Results Seven‐hundred‐seventeen patients (mean age, 49.2 years; female sex, 57.9%; 450 H. pylori‐positive and 267 H. pylori‐negative patients) were enrolled. All endoscopic gastritis cases in the Kyoto classification were associated with high corpus and antral USS scores for neutrophil activity and chronic inflammation. A subanalysis was performed for H. pylori‐positive patients. Regarding atrophy and intestinal metaplasia, endoscopic findings were associated with USS scores. Enlarged folds, nodularity, and diffuse redness were associated with high corpus USS scores for neutrophil activity and chronic inflammation, but with low antral USS scores for atrophy and intestinal metaplasia. The Kyoto classification scores were also associated with the pathological topographic distribution of neutrophil activity and intestinal metaplasia. Conclusions Among H. pylori‐positive individuals, endoscopic and pathological diagnoses were consistent with atrophy and intestinal metaplasia. Enlarged folds, nodularity, and diffuse redness were associated with pathological inflammation (neutrophil activity and chronic inflammation) of the corpus; however, they were inversely associated with pathological atrophy and intestinal metaplasia. The endoscopy‐based Kyoto classification of gastritis partially reflects pathology.
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.15693