An Endoscopic Recognition of the Atrophic Border and its Significance in Chronic Gastritis

Abstract

The endoscopic atrophic border is a boundary between the pyloric and fundic gland territories, which is endoscopically recognized by discriminating differences in color and height of the gastric mucosa. The existence of superficial gastritis might exag-gerate the color and niveau differences, thus making it much easier to recognize the atrophic border. And also, according to the results of precise biopsy taken perpendicularly across the endoscopic atrophic border, it might be the boundary of histological atrophy and nonatrophy. In other words, the endoscopic atrophic border might be the boundary both of gland type and of atrophy. As a supplemental approach, a selective application of congo red method was endoscopically performed, which suggests that this might be a physiological border as well.Additionally, a classification of the atrophic pattern was attempted according to the location of the endoscopic atrophic border in the stomach, which revealed a close relationship with gastric analysis.Endoscopy 3 (1969) 87-97

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

“…The size of the diaphragmatic hiatus was assessed during endoscopic observation by comparing the width of the cardiac opening with the diameter of the shaft used for endoscopy at the cardiac portion and divided into three categories (<1.0, 1.0-2.0, >2.0 cm). The degree of gastric mucosal atrophy was endoscopically evaluated using the classification of Kimura and Takemoto, by which gastric mucosal atrophy was divided into six groups (C1, C2, C3, O1, O2, O3) (25). It has been shown that gastric acid secretion in patients with gastric mucosal atrophy decreases successively from C1 to O3 (26).…”

What Have We Accomplished in Endoscopic Image Analysis for Atrophic Gastritis?

“…Mapping studies of biopsy findings suggested that chronic atrophic gastritis develops from the lesser curvature of the lower gastric body and extends upward and laterally in the corpus. 13 Furthermore, the presence of IM in the lesser curvature of the corpus had the strongest association with cancer risk. 14 Form these observations, 5,6,14 we can easily understand that specific endoscopic findings well matched with IM and atrophic gastritis can be a great help to understand the high-risk group without multiple biopsies.…”

“…4). 13 The gastric mucosa on the border itself and on the fundic gland side has neutrophil and mononuclear cell infiltration but no atrophy or IM. By contrast, on the pyloric side of the border, the mucosa shows atrophy of the fundic glands with or without IM.…”

“…1). 13,15 Recently, gastric mucosal atrophy is defined histologically as the loss of appropriate glands (Fig. 2).…”

“…3), and this zone has subsequently become known as the endoscopic atrophic border. 13 Endoscopic atrophic border is rather easily recognized, when it becomes familiar, by discriminating differences both in color and niveau of the mucosa (Fig. 4).…”