Kotelevets SM, Chekh SA, Chukov SZ. Updated Kimura-Takemoto classification of atrophic gastritis. World J Clin Cases 2021; 9(13): 3014-3023 [PMID: 33969087 DOI: 10.12998/wjcc.v9.i13.3014]
Corresponding Author of This Article
Sergey M Kotelevets, MD, Professor, Department of Therapy, Medical Institute, North Caucasus State Academy for Humanities and Technologies, Stavropolskaya Street 36, Cherkessk 369000, Russia. smkotelevets@mail.ru
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2021; 9(13): 3014-3023 Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3014
Updated Kimura-Takemoto classification of atrophic gastritis
Sergey M Kotelevets, Sergey A Chekh, Sergey Z Chukov
Sergey M Kotelevets, Department of Therapy, Medical Institute, North Caucasus State Academy for Humanities and Technologies, Cherkessk 369000, Russia
Sergey A Chekh, Department of Software Development, Institute of Applied Mathematics and Information Technology, North Caucasus State Academy of Humanities and Technologies, Cherkessk 369000, Russia
Sergey A Chekh, Department of Mathematics, Institute of Applied Mathematics and Information Technology, North Caucasus State Academy of Humanities and Technologies, Cherkessk 369000, Russia
Sergey Z Chukov, Department of Pathological Anatomy, Stavropol State Medical University, Stavropol 355017, Russia
Author contributions: Kotelevets SM designed the research, collected the data, and wrote the paper; Chekh SA analyzed the data, performed the statistical processing, and revised the manuscript for final submission; Chukov SZ performed the histological investigations, interpreted the biopsy results, and revised the manuscript for final submission.
Institutional review board statement: This study was approved by the Ethical Committee of North Caucasian State Academy (Minutes No. 14/20 dated 29.06.2020). The work was performed in accordance with the Declaration of Helsinki (2000) of the World Medical Association.
Informed consent statement: All patients provided informed written consent.
Conflict-of-interest statement: The authors declare that they have no potential conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sergey M Kotelevets, MD, Professor, Department of Therapy, Medical Institute, North Caucasus State Academy for Humanities and Technologies, Stavropolskaya Street 36, Cherkessk 369000, Russia. smkotelevets@mail.ru
Received: November 6, 2020 Peer-review started: November 6, 2020 First decision: January 23, 2021 Revised: February 1, 2021 Accepted: March 19, 2021 Article in press: March 19, 2021 Published online: May 6, 2021 Processing time: 166 Days and 18.6 Hours
ARTICLE HIGHLIGHTS
Research background
The Updated Sydney system does not meet modern requirements for the study of atrophic gastritis. Thus, for effective prevention of gastric cancer, a new classification of gastritis is needed.
Research motivation
Development of a further updated version of the Updated Kimura-Takemoto morphological classification will allow for more efficient implementation of the visual endoscopic classification of atrophic gastritis.
Research objectives
The proposed Updated Kimura-Takemoto morphological classification of gastritis will further efforts to achieve the overall goal of preventing gastric cancer through more accurate identification and morphological monitoring of severe atrophic gastritis (gastric precancer).
Research methods
Kimura and Takemoto originally developed a visual endoscopic assessment system for the gastric mucosa, naming the stages of development of atrophic gastritis. In accordance with these stages, we obtained six biopsies from each patient and performed subsequent histological examination. These biopsies included specimens from the antrum (n = 1) and the gastric corpus (n = 5). Of note, for each patient, two of the gastric corpus biopsy specimens corresponded topographically to the Updated Sydney system and the Updated Kimura-Takemoto system.
Research results
The results of the study demonstrated a significantly better sensitivity of the updated morphological Kimura-Takemoto classification for the diagnosis of atrophic gastritis (including severe atrophic gastritis) compared to the Updated Sydney system.
Research conclusions
A new morphological method for the detection, morphological verification and morphological monitoring of atrophic gastritis is proposed: The Updated Kimura-Takemoto morphological classification system. The Kimura-Takemoto hypothesis that atrophy of the gastric mucosa extends from the antrum to the greater curvature of the gastric corpus was confirmed morphologically via the newly developed system in 82% of patients with indicated atrophic gastritis.
Research perspectives
Study of the morpho-functional relationships in atrophic gastritis using the Updated Kimura-Takemoto classification system is promising for finding the best serological markers of atrophic gastritis for future serological screening of precancerous changes in the gastric mucosa.
