Assessment of Endoscopic Gastric Atrophy according to the Kimura-Takemoto Classification and Its Potential Application in Daily Practice
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초록
The assessment of endoscopic gastric atrophy (EGA) according to the Kimura-Takemoto classification has been reported to correlatewell with histological assessment. Although agreement among beginner endoscopists was less than that among experiencedendoscopists, it has been shown that agreement level could markedly improve and remained stable after proper training. Severalcohort studies have consistently shown that the severity of EGA at baseline is significantly associated with the presence of advancedprecancerous gastric lesions and gastric cancer, as well as the development of gastric cancer in future. Patients with moderate-to-severeEGA still have high risk of gastric cancer even after successful Helicobacter pylori eradication and should be candidates for gastriccancer surveillance. The assessment of EGA, therefore, could be used as a preliminary tool to identify individuals at high risk forgastric cancer. In this paper, we review the agreement on mucosal atrophy assessment between the Kimura-Takemoto classification andhistology as well as the potential application of this endoscopic classification to identify precancerous gastric lesions and gastric cancerin daily practice.
Abstract
The assessment of endoscopic gastric atrophy (EGA) according to the Kimura-Takemoto classification has been reported to correlatewell with histological assessment. Although agreement among beginner endoscopists was less than that among experiencedendoscopists, it has been shown that agreement level could markedly improve and remained stable after proper training. Severalcohort studies have consistently shown that the severity of EGA at baseline is significantly associated with the presence of advancedprecancerous gastric lesions and gastric cancer, as well as the development of gastric cancer in future. Patients with moderate-to-severeEGA still have high risk of gastric cancer even after successful Helicobacter pylori eradication and should be candidates for gastriccancer surveillance. The assessment of EGA, therefore, could be used as a preliminary tool to identify individuals at high risk forgastric cancer. In this paper, we review the agreement on mucosal atrophy assessment between the Kimura-Takemoto classification andhistology as well as the potential application of this endoscopic classification to identify precancerous gastric lesions and gastric cancerin daily practice.
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