Background : Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods : One hundred and fifty-five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results : Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion : Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated.

Of the 205 patients treated by endoscopic injection sclerotherapy in the past 8 years and 4 months, 70 patients (34.1%) have survived more than 3 years. There were more Child's class A patients (p < 0.05) and fewer Child's C patients (p < 0.01) in this group as compared to 51 patients who died within 3 years. In addition, complications due to hepatoma were significantly lower (p < 0.01) in this group. The long‐term cumulative survival rates of those who had already survived over 3 years were 82% at the 5‐year and 78% at the 7‐year follow‐up. There was no significant difference among 3 groups classified by severity of liver damage or timing of the therapy. Rebleeding was noted in 13 patients (18.3%) and the cumulative bleeding rates were 9% at the 1‐year, 14% at the 3‐year, 18% at the 5‐year and 21% at the 7‐year follow‐up. In 12 of these patients hemostasis was obtained by the second sclerotherapy. There was no significant difference in the long‐term prognosis between patients who experienced repeat bleeding, and those who did not. Endoscopic findings in patients with rebleeding were characteristic in that the red color sign remained pronounced despite the fact that the varices had shrunk from F2 or larger to F1 in 6 patients. Bleeding occurred from the gastric varices in 4 patients. One of them died due to gastric bleeding, but 3 were operated on after sclerotherapy. For improving prognosis, it is important to carefully observe the clinical course and to perform additional aggressive treatments for complete obliteration of varices.

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