Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3014
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
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.
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.
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).
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.
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.
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.
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.