Predictive value of nomogram based on Kyoto classification of gastritis to diagnosis of gastric cancer

Lin, Jiejun; Su, Heng; Zhou, Qilai; Pan, Jie; Zhou, Leying

doi:10.1080/00365521.2021.2023626

Cited by 5 publications

(6 citation statements)

References 26 publications

(14 reference statements)

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“…Furthermore, as we want more precise data to predict, it is essential to check the Kyoto Classification score’s accuracy with further high-quality research. [34] A more accurate Kyoto Classification score should be determined via more studies in order to practice precision medicine. Additional assessment markers, such as white sticky mucus and spotty redness, should be included in the Kyoto Classification of Gastritis.…”

Section: Discussionmentioning

confidence: 99%

The significance of endoscopic Kyoto classification of gastritis in the gastric cancer risk assessment: A systematic review and meta‑analysis

et al. 2023

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Background: Kyoto Classification of Gastritis is a newly proposed gastric cancer risk assessment in recent years. It selects important gastroscopic manifestations that have been reported and calculates score values. Although it has been extensively employed in clinical practice, there is no thorough review or systematic summary of its usage. Methods: We looked for works published before May 2022 on the correlation between the Kyoto Classification of Gastritis and gastric cancer (GC) risk in Web of Science, EMBASE, China National Knowledge Infrastructure, PubMed, Wanfang database, and other suitable sources. Statistical analysis was carried out using Stata 14.0 and RevMan 5.40. Two statistical methods were employed. Results: Eight case-control studies involving 6927 patients (continuous variables group: 1961 patients; dichotomy variables group: 4966 patients) were included, and the meta-analysis results showed a significant association between Kyoto Classification of Gastritis and GC. A Kyoto classification score ≥ 4 might indicate a risk of GC (odds ratios 7.30; 95% confidence intervals [CI] 3.62–14.72; P < .00001. There was a significant difference between gastritis and GC scores (mean difference [MD] 0.86; 95% CI 0.73–0.99; P < .00001). Moreover, we found that intestinal metaplasia and atrophy highly affected the Kyoto Classification score (MD = 0.35, MD = 0.72 95% CI 0.20–0.50,0.56–0.88). However, there was considerable heterogeneity in both statistical analyses. We found the source of heterogeneity in the first analysis method but failed to find it in the second analysis method, which may be due to the small number of studies. Conclusions: The Kyoto Classification of gastritis score is crucial for detecting early stomach cancer. A score >4 suggests a significant risk for gastric cancer, with atrophy and intestinal metaplasia having the most impact. This score may be promoted at primary hospitals; however, because of the small number and quality of included studies, the results mentioned above need to be verified by randomized control trials with large samples and high-quality methods.

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Section: Discussionmentioning

confidence: 99%

The significance of endoscopic Kyoto classification of gastritis in the gastric cancer risk assessment: A systematic review and meta‑analysis

et al. 2023

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“…The total Kyoto scores of patients with GC, H. pylori -infected GC, and H. pylori -eradicated GC were 4.0-4.6, 4.8-5.6, and 4.2, respectively[ 44 , 50 , 58 , 60 ]. A high total Kyoto score was associated not only with GC (ORs = 1.5-1.6), but also with both diffuse-type and intestinal-type GCs (ORs = 1.3 and 1.7, respectively, Table 4 )[ 44 , 61 ]. Additionally, some investigators showed that the incidence of GC increased stepwise with the total Kyoto scores of 0-1, 2-3, ≥ 4, and that the AUC of the nomogram to predict GC using the total Kyoto score was 0.79[ 31 , 61 ].…”

Section: Gc Risk Of Kyoto Classificationmentioning

confidence: 99%

“…A high total Kyoto score was associated not only with GC (ORs = 1.5-1.6), but also with both diffuse-type and intestinal-type GCs (ORs = 1.3 and 1.7, respectively, Table 4 )[ 44 , 61 ]. Additionally, some investigators showed that the incidence of GC increased stepwise with the total Kyoto scores of 0-1, 2-3, ≥ 4, and that the AUC of the nomogram to predict GC using the total Kyoto score was 0.79[ 31 , 61 ]. Taken together, a total Kyoto score of 4 or more is useful for determining GC risks, including histological subtypes, even after H. pylori eradication.…”

Section: Gc Risk Of Kyoto Classificationmentioning

confidence: 99%

Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis

Toyoshima¹,

Nishizawa²

2022

World J Gastroenterol

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This editorial provides an update of the recent evidence on the endoscopy-based Kyoto classification of gastritis, clarifying the shortcomings of the Kyoto classification, and providing prospects for future research, with particular focus on the histological subtypes of gastric cancer (GC) and Helicobacter pylori ( H. pylori ) infection status. The total Kyoto score is designed to express GC risk on a score ranging from 0 to 8, based on the following five endoscopic findings: Atrophy, intestinal metaplasia (IM), enlarged folds (EF), nodularity, and diffuse redness (DR). The total Kyoto score reflects H. pylori status as follows: 0, ≥ 2, and ≥ 4 indicate a normal stomach, H. pylori -infected gastritis, and gastritis at risk for GC, respectively. Regular arrangement of collecting venules (RAC) predicts non-infection; EF, nodularity, and DR predict current infection; map-like redness (MLR) predicts past infection; and atrophy and IM predict current or past infection. Atrophy, IM, and EF all increase the incidence of H. pylori -infected GC. MLR is a specific risk factor for H. pylori -eradicated GC, while RAC results in less GC. Diffuse-type GC can be induced by active inflammation, which presents as EF, nodularity, and atrophy on endoscopy, as well as neutrophil and mononuclear cell infiltration on histology. In contrast, intestinal-type GC develops via atrophy and IM, and is consistent between endoscopy and histology. However, this GC risk-scoring design needs to be improved.

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“…The interobserver agreement for endoscopic atrophy diagnosis and grading was reported to improve after training and remain stable [16]. Additionally, the incidence of GC increased gradually with EKC scores of 0–1, 2–3, and 4 [8, 17, 18]. As gastric atrophy is a component of EKC and the classification EKC also integrates other components related to the risk of GC, such as diffuse redness, which is associated with active inflammation, and IM, it is presumed that EKC can predict GC risk better than KTC, which is based on gastric atrophy assessment alone.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Kyoto and Kimura-Takemoto Classifications Are Comparable in Predicting High-Risk Gastric Precancerous Lesions

Nguyen,

Quach,

et al. 2024

Digestion

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Background/aims: Severe and extensive gastric atrophy, extensive or incomplete gastric intestinal metaplasia, and gastric dysplasia are considered high-risk gastric precancerous lesions (HGPLs). Endoscopic findings based on the endoscopic Kyoto classification (EKC) and the Kimura-Takemoto classification (KTC) have been reported to be significantly associated with HGPLs. This study aimed to compare these two classifications in predicting active Helicobacter pylori (H. pylori) infection and HGPLs. Methods: This is a cross-sectional study conducted on naïve dyspeptic patients who underwent upper gastrointestinal endoscopy at a tertiary hospital. Endoscopic findings were scored according to the EKC and KTC classifications. Mapping biopsies were taken, and H. pylori infection was determined using a locally validated rapid urease test and histology. The performance of EKC was compared with that of KTC using the area under the receiver operating characteristic curve (AUC) in predicting active H. pylori infection and HGPLs. Results: There were 292 patients with a median age of 46 and a male-to-female ratio of 1:1. The rates of active H. pylori infection and HGPLs were 61.3% and 14.0%, respectively. The EKC was better than the KTC in predicting active H. pylori infection (AUC: 0.771 vs. 0.658, respectively; p< 0.001). However, these two classifications had comparable performance in predicting HGPLs (AUC: 0.792 vs. 0.791, respectively; p = 0.956). Conclusion: Compared to EKC, KTC is inferior in predicting active H. pylori infection but has comparable performance in predicting HGPLs.

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Predictive value of nomogram based on Kyoto classification of gastritis to diagnosis of gastric cancer

Cited by 5 publications

References 26 publications

The significance of endoscopic Kyoto classification of gastritis in the gastric cancer risk assessment: A systematic review and meta‑analysis

The significance of endoscopic Kyoto classification of gastritis in the gastric cancer risk assessment: A systematic review and meta‑analysis

Kyoto classification of gastritis: Advances and future perspectives in endoscopic diagnosis of gastritis

Endoscopic Kyoto and Kimura-Takemoto Classifications Are Comparable in Predicting High-Risk Gastric Precancerous Lesions

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