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Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity
Authors:Osamu Toyoshima  Toshihiro Nishizawa  Shuntaro Yoshida  Yoshiki Sakaguchi  Yousuke Nakai  Hidenobu Watanabe  Hidekazu Suzuki  Chizu Tanikawa  Koichi Matsuda  Kazuhiko Koike
Abstract:BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer risk.AIM To investigate the association between Kyoto classification and the topographic distribution of neutrophil activity.METHODS Kyoto classification score, ranging from 0 to 8, consisted of atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness. Neutrophil activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the antrum. The participants were divided into four categories, inactive stomach, antrumpredominant gastritis, pangastritis, and corpus-predominant gastritis, based on the topographic distribution of neutrophil activity. Effects of sex, age, body mass index, drinking habit, smoking habit, family history of gastric cancer, serum Helicobacter pylori(H. pylori) antibody, and Kyoto score on topography of neutrophil infiltration were analyzed.RESULTS A total of 327 patients(comprising 50.7% women, with an average age of 50.2 years) were enrolled in this study. H. pylori infection rate was 82.9% with a mean Kyoto score of 4.63. The Kyoto score was associated with the topographic distribution of neutrophil activity. Kyoto scores were significantly higher in the order of inactive stomach, antrum-predominant gastritis, pangastritis, and corpuspredominant gastritis(3.05, 4.57, 5.21, and 5.96, respectively). Each individual score of endoscopic findings(i.e., atrophy, intestinal metaplasia, enlarged folds, nodularity, and diffuse redness) was correlated with the topographic distribution of neutrophil activity. On multivariate analysis, the Kyoto score, age, and serum H. pylori antibody were independently associated with the topographic distribution of neutrophil activity.CONCLUSION The Kyoto classification score was associated with the topographic distribution of neutrophil activity.
Keywords:Kyoto classification   Helicobacter pylori   Neutrophil activity   Updated Sydney System   Gastritis   Gastric cancer   Endoscopy   Pathology
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