Endoscopic Diagnosis and Classification of Atrophic Gastritis and Intestinal Metaplasia

ABSTRACT

Gastritis is the term used to describe the inflammatory condition of the stomach. However, the ambiguous application of this term in clinical practice, such as in endoscopic or histological diagnosis, makes its diagnosis and treatment unclear. Atrophic gastritis is the most common finding in screening endoscopy, especially in patients with high risk of gastric adenocarcinoma; thus, definite diagnosis of the premalignant condition is important. Several classification systems and associated terminologies have been used to define the inflammatory condition of the stomach. However, many of them are based on histological findings, and their clinical application is limited in endoscopic diagnosis. Recently, with the advancement of endoscopic imaging techniques such as narrow-band imaging, atrophy and intestinal metaplasia can now be defined more precisely. Currently, many attempts have been made to classify the condition of the stomach on the basis of endoscopic findings, focusing on the risk of gastric adenocarcinoma and the presence of Helicobacter pylori.