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

作　　者：Osamu Toyoshima Toshihiro Nishizawa 

机构地区：[1]Department of Gastroenterology,Toyoshima Endoscopy Clinic,Tokyo 157-0066,Japan [2]Department of Gastroenterology and Hepatology,International University of Medicine and Welfare,Narita 286-8520,Japan

出　　处：《World Journal of Gastroenterology》2022年第43期6078-6089,共12页世界胃肠病学杂志（英文版）

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 noninfection;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.

关 键 词：Kyoto classification GASTRITIS ENDOSCOPY Gastric cancer HISTOLOGY Helicobacter pylori 

分 类 号：R573.3[医药卫生—消化系统]