Quach Duc Trong, Hiyama Toru
Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Department of Gastroenterology, Gia-Dinh People's Hospital, Ho Chi Minh City, Vietnam.
Clin Endosc. 2019 Jul;52(4):321-327. doi: 10.5946/ce.2019.072. Epub 2019 Jul 22.
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.
据报道，根据木村 - 竹本分类法进行的内镜下胃萎缩（EGA）评估与组织学评估具有良好的相关性。尽管初级内镜医师之间的一致性低于经验丰富的内镜医师，但研究表明，经过适当培训后，一致性水平可显著提高并保持稳定。多项队列研究一致表明，基线时EGA的严重程度与高级别胃癌前病变和胃癌的存在以及未来胃癌的发生显著相关。即使成功根除幽门螺杆菌，中重度EGA患者仍有较高的胃癌风险，应作为胃癌监测的对象。因此，EGA评估可作为识别胃癌高危个体的初步工具。在本文中，我们综述了木村 - 竹本分类法与组织学在黏膜萎缩评估方面的一致性，以及这种内镜分类法在日常实践中识别胃癌前病变和胃癌的潜在应用。
