Endoscopic Gastric Atrophy and H. pylori Evaluation

In the first year, EGD was performed with an EG-L580NW scope and light source LASEREO (FUJIFILM Medical Co., Ltd., Tokyo, Japan). At endoscopic examination, we evaluated the degree of atrophy and H. pylori infection status [6 (link)]. Gastric mucosal atrophy was classified by degree into grades C-0 (none), C-1, C-2, C-3, O-1, O-2, and O-3 according to the endoscopic–atrophic-border scale described by Kimura and Takemoto [9 (link)–11 (link)]. Regarding H. pylori infection status, findings described in the Kyoto classification of gastritis [5 ] such as presence or absence of regularly arranged collecting venules, enlarged gastric folds, nodularity, diffuse and/or spotty redness, and map-like or patchy redness of the gastric mucosa were evaluated. Based on these findings, gastric mucosa was endoscopically classified into non-gastritis (looking like never infected with H. pylori), active gastritis (current H. pylori infection), inactive gastritis (past infection), or undefined (equivocal or status of gastritis difficult to judge). The main diagnostic criteria were gastric mucosal atrophy with diffuse and/or spotty redness for active gastritis; atrophy with map-like redness and/or patchy redness for inactive gastritis; and regularly arranged collecting venules in the lesser curvature of the gastric angle for non-gastritis [6 (link)].