Gastric cancer prevention targeted on risk assessment: the Kyoto Classification of Gastritis

Abstract

Objective To explore the value of Endoscopic performance score for risk of gastric cancer. Methods 578 patients with chronic atrophic gastritis were selected as the study subjects. We selected endoscopic appearance and background mucosal appearance, biopsy pathology, and H.Pylori examination, to analyze the relationship between endoscopic performance score and gastric carcinoma. Results In 578 patients with chronic atrophic gastritis, 156 cases LGIN and 86 cases HGIN were detected. The detection rate of HGIN in male patients was 22.3% (57/256) and that of female patients was 9.0 % (29/322). The difference was statistically significant (P<0.001). There are Kyoto gastritis score less than 3, 213 cases, score 4–6, 198 cases, score 7–8, 167 cases. The scoring grade was significantly correlated with the occurrence and degree of intraepithelial neoplasia (R=0.260, P < 0.001). The total score of patients with gastric cancer in the fundus of the stomach and cardia was significantly increased (P< 0.01). In Multivariate analysis, the risk factor for gastric cancer is intestinal metaplasia, with an OR value of 4.811(95% CI 2.905-7.967, P<0.001). Conclusion Detecting the patients at high risk and making an appropriate diagnosis is crucial for achieving total eradication of gastric cancer. The score of endoscopic performance in the Kyoto gastritis classification is useful for detecting these patients.