The Correlation Between Kimura-takemoto Classification And OLGA Staging System In Chronic Gastristis

Objective: To explore the correlation between the Kimura-Takemoto classification and OLGA staging system and factors which affect the consistency of the two systems' diagnostic results.To promote the stratification of the risk of gastric cancer in patients with chronic atrophic gastritis(CAG)by using the Kimura-Takemoto classification.Methods: 230 Patients who had upper gastrointestinal symptoms such as abdominal distension,belching and dull pain took the examination of endoscopy at the affiliated hospital of Qingdao university.The gastric atrophy was assessed according to Kimura-Takemoto classification.The patients were classified into two types : closed type and open type.Each type was subdivided into three subtypes : C1,C2,C3,and O1,O2,O3.C1 : the atrophy limit was confined to the antrum,C2 : the atrophy limit was above the gastric angle,C3 : the atrophy limit exceeded the gastric angle and was close to the cardia,O1 : the atrophy limit was just over the cardia,O2 : the atrophic boundary had spread throughout the fundus of the stomach,and the O3 : atrophic boundary extended to the body of the stomach.Gastritis stage was established according to OLGA staging system.Used SPSS 19.0 to analyze the correlation between the two systems and the consistency of diagnostic results.Results: Kimura-Takemoto classification and OLGA system had a moderate correlation(r=0.669,P<0.05).The two assessment systems had a medium agreement in the diagnosis of chronic gastritis with a Kappa value of 0.456(P<0.05).Multivariate logistic regression analysis showed that Hp infection(OR = 3.113,95% CI: 1.71-5.668,P<0.05),smoking(OR = 3.206,95% CI: 1.35-7.661,P<0.05),taking NSAIDs(OR =5.018,95% CI: 1.588-15.861,P<0.05)were the factors which affected the consistency of the two systems' diagnostic results,while alcohol,bile reflux,age and gender factors did not obviously affect the consistency.Conclusion: The OLGA system had a strong correlation with Kimura-Takemoto classification and the consistency of the diagnostic results of the two systems was also ideal.Smoking,Hp infection and non-steroidal anti-inflammatory drugs(NSAIDs)are the factors that affect the consistency of the diagnosis results of the two systems.After excluding the factors,the two systems are highly correlated and the diagnostic results are highly consistent.Therefore,we can use Kimura-Takemoto classification to assess the risk of gastric cancer in patients with background mucosa and to screen out high-risk groups by rapid detection of high-risk background mucosa in order to achieve the purpose of detecting early gastric cancer.