Assessment of Endoscopic Gastric Atrophy according to the Kimura-Takemoto Classification and Its Potential Application in Daily Practice

Abstract

The assessment of endoscopic gastric atrophy (EGA) according to the Kimura-Takemoto classification has been reported to correlate well with histological assessment. Although agreement among beginner endoscopists was less than that among experienced endoscopists, it has been shown that agreement level could markedly improve and remained stable after proper training. Several cohort studies have consistently shown that the severity of EGA at baseline is significantly associated with the presence of advanced precancerous gastric lesions and gastric cancer, as well as the development of gastric cancer in future. Patients with moderate-to-severe EGA still have high risk of gastric cancer even after successful Helicobacter pylori eradication and should be candidates for gastric cancer surveillance. The assessment of EGA, therefore, could be used as a preliminary tool to identify individuals at high risk for gastric cancer. In this paper, we review the agreement on mucosal atrophy assessment between the Kimura-Takemoto classification and histology as well as the potential application of this endoscopic classification to identify precancerous gastric lesions and gastric cancer in daily practice.

Clinical, demographic, and endoscopic characteristics of naive Helicobacter pylori positive and negative patients: A retrospective analysis

“…H. pylori ve eşlik ettiği hastalıklar ile ilgili çalışmalar son dönemde endoskopik olarak mukoza değerlendirmesi üzerine yoğunlaşmıştır (7)(8)(9)(10)(11). Çalışmada hastaların endoskopik bulguları açısından bakıldığında H. pylori pozitif hastalarda, daha fazla bulbusta ülser olduğu fakat istatistiki anlamlılık olmadığı gözlendi.…”

The simplified Kyoto classification score is consistent with the ABC method of classification as a grading system for endoscopic gastritis

“…Endoscopic atrophy was diagnosed based on the Kimura and Takemoto classification. (17)(18)(19) Non-atrophy and C1 were scored as Atrophy score 0, C2 and C3 as Atrophy score 1, and O1 to O3 as Atrophy score 2.…”

Chronic atrophic gastritis detection with a convolutional neural network considering stomach regions

“…We regarded subjects whose diagnosis results were “normal” as non-CAG subjects and the other subjects as CAG subjects. In contrast, in the endoscopic examination, subjects were classified into seven categories, i.e ., no atrophic change (C0), three closed types of atrophic gastritis (C1, C2, C3) and three open types of atrophic gastritis (O1, O2, O3) based on the Kimura-Takemoto seven-grade classification[ 23 ]. Since C1 is defined as the atrophic borderline, we excluded subjects whose diagnosis results were C1 from the dataset.…”