Evaluation of Endoscopic Characteristics in a New Gastritis Classification System

Abstract: The Sydney System is a relatively new classification system for gastritis that includes two divisions: histological and endoscopic. To evaluate the endoscopic division, we assessed the endoscopic appearance of the gastric mucosa according to the Sydney System. One thousand seventeen cases of gastritis were diagnosed endoscopically from July 1992 through June 1993. According to the eight categories of endoscopic gastritis used in the Sydney System, 58.8% of cases were diagnosed as atrophic gastritis, 18.7% as erythematous gastritis, 7.8% as raised erosive gastritis, 5.0% as flat erosive gastritis, 5.0% as hemorrhagic gastritis, 3.1% as congestive gastropathy, and 1.5% as enterogastric reflux gastritis. The topography of atrophic gastritis correlated significantly with the extent of endoscopic atrophy, while the severity of the atrophic gastritis grading correlated significantly with the histological severity of atrophy. Although some difficulties remain with regard to the description of endoscopic gastritis in the Sydney System, these issues could be resolved by modifying a few parts of the descriptive definition of gastritis. Our results indicate that the endoscopic division of the Sydney System is applicable to the classification of gastritis in Japanese patients.