scholarly journals The Updated Sydney System: Classification and Grading of Gastritis as the Basis of Diagnosis and Treatment

2001 ◽  
Vol 15 (9) ◽  
pp. 591-598 ◽  
Author(s):  
Manfred Stolte ◽  
Alexander Meining
Keyword(s):  
Helicobacter Pylori ◽  
Distribution Patterns ◽  
Helicobacter Heilmannii ◽  
Chemically Induced ◽  
Topographical Distribution ◽  
Sydney System ◽  
Updated Sydney System ◽  
H Pylori ◽  
First Time ◽  
Morphological Distribution

In recent years, the importance of the histological diagnosis of gastritis on the basis of routinely obtained antral and corpus biopsies has increased enormously, which is owed not least of all to the discovery ofHelicobacter pylori. The introduction of the Sydney system made it possible, for the first time, to grade histological parameters, identify topographical distribution and, finally, make a statement about the etiopathogenesis of the gastritis. Of pathogenetic importance is, in the first instance, the differentiation between gastritis with and gastritis withoutH pyloriinfection. The group ofH pylori-associated gastritis can be further subdivided into forms of gastritis whose morphological distribution patterns usually identify them as sequelae ofH pyloriinfection, while the group of gastritis unassociated withH pylori, can be differentiated into autoimmune, chemically induced reactive gastritis, ex-H pylorigastritis,Helicobacter heilmanniigastritis, Crohn's gastritis and a number of special forms of gastritis.

scholarly journals Distribución de estadios de OLGA y OLGIM según edad y estado del Helicobacter pylori en un hospital público nivel III en Lima, Perú

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Andrea Carlin Ronquillo ◽  
Alex Ventura León ◽  
Jorge L Espinoza Ríos ◽  
Eduar A Bravo Paredes ◽  
Paúl Gómez Hinojosa ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
High Risk ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Intestinal Metaplasia ◽  
Endoscopic Control ◽  
Staging Systems ◽  
Sydney System ◽  
Group 5 ◽  
Updated Sydney System ◽  
H Pylori

Introduction. The operative link for gastritis assessment (OLGA) and the operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been suggested to provide risk of assessment for gastric cancer. Objective. To evaluate the distribution of OLGA and OLGIM staging by age and Helicobacter pylori status. Material and methods. We studied 197 subjects undergoing elective upper gastrointestinal endoscopy. The presence of the H. pylori and histological changes were evaluated using the updated Sydney system. Stages III and IV of OLGA/OLGIM were considered high risk stages. Results. The H. pylori rate was 56.85% (112/197). High-risk OLGA/OLGIM cases were rare: 7/112 (6.5%) cases of OLGA in the H. pylori positive group and 6/85 (7%) in the H. pylori negative group; 5 (4.4%) cases of OLGIM in the H. pylori positive and 6 (7%) in the H. pylori negative. The proportion of advanced stages of OLGA and OLGIM increased with age (p < 0.001). High-risk OLGA was not found before age 40 regardless of the presence of H. pylori, but increased to 16.2%, 10.3%, 17.3% and 40.8% in subjects in the fourth, fifth, sixth and seventh decade of life respectively. The OLGIM high risk showed a similar trend: 0% before 40 years and up to 22.6% in people of 70 years. Conclusions. High-risk OLGA/OLGIM cases are infrequent before age 40 and increase significantly with age. No relation was found with the presence of the H. pylori. According to these protocols, only a fifth of the patients would strictly require endoscopic control.

scholarly journals Rebamipide Improves Chronic Inflammation in the Lesser Curvature of the Corpus afterHelicobacter pyloriEradication: A Multicenter Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Tomoari Kamada ◽  
Motonori Sato ◽  
Tadashi Tokutomi ◽  
Tetsuo Watanabe ◽  
Takahisa Murao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Chronic Inflammation ◽  
Epidemiologic Studies ◽  
Untreated Group ◽  
Primary Endpoints ◽  
Sydney System ◽  
Updated Sydney System ◽  
H Pylori ◽  
Lesser Curvature

Background and Aim. Although many epidemiologic studies have shown thatHelicobacter pylorieradication has prophylactic effects on gastric cancer, it does not completely eliminate the risk of gastric cancer. We aimed to investigate the changes in histological gastritis in patients receiving rebamipide treatment afterH. pylorieradication.Methods. 206 patients who had undergoneH. pylorieradication were evaluated. Of these, 169 patients who achieved successful eradication were randomly allocated to 2 groups: the rebamipide group (n= 82) and the untreated group (n= 87). The primary endpoints were histopathological findings according to the updated Sydney system at the start of the study and after 1 year.Results. Final assessment for histological gastritis was possible in 50 cases from the rebamipide group and 53 cases from the untreated group. The activity and atrophy improved in both the rebamipide and untreated groups, and no significant intergroup differences were observed. Chronic inflammation affecting the lesser curvature of the corpus was significantly improved in the rebamipide group compared to in the untreated group (1.12±0.08versus1.35±0.08;P= 0.043).Conclusions. Rebamipide treatment afterH. pylorieradication alleviated chronic inflammation in the lesser curvature of the corpus compared to that in the untreated group. This trial is registered withUMIN000002369.

scholarly journals Evaluation of chronic gastritis with Helicobacter pylori using updated Sydney system

2021 ◽  
Vol 9 (9) ◽  
pp. 2728
Author(s):  
Anjana M. L. ◽  
Kavitha Yevoor
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Histological Evaluation ◽  
Statistical Association ◽  
Histopathological Changes ◽  
Biopsy Specimens ◽  
Sydney System ◽  
Updated Sydney System ◽  
H Pylori ◽  
Significant Statistical Association

Background: Helicobacter pylori has been established as a major etiological factor in the pathogenesis of chronic gastritis. The aim of the study was to interpret the histopathological changes in chronic gastritis using updated Sydney system and the association with H. pylori infection.Methods: This was a 3 years study in which 62 gastric endoscopic mucosal biopsies taken from patients presenting with dyspepsia were included. Slides were stained with routine H and E and Giemsa for H. pylori detection in chronic gastritis cases. Grading of the variables were done with reference to Sydney system of classification.Results: Out of 62 gastric biopsy specimens, 55 cases (88.7%) were histopathological diagnosed as chronic gastritis. Among chronic gastritis, 21 (38%) cases showed H. pylori and majority of these being moderately (2+) positive. 27 (49%) cases showed neutrophilic activity with most of them showed mild (1+) activity. Chronic inflammation was seen 52 (94.5%) with majority of these graded as moderate (2+). Intestinal metaplasia was seen in 8 (14.5%) of cases with majority being mild (1+). Atrophy was seen only in 3 (5.4%) of cases with majority being mild (1+). Significant statistical association was found between H. pylori and neutrophilic activity (p<0.001).Conclusions: Histological evaluation of chronic gastritis using updated Sydney system of classification helps in detection of H. pylori infection and prevents further progression of the disease. 

scholarly journals Helicobacter pylori infection and chronic gastritis; use of the Updated Sydney System in histopathological evaluation of gastritis

2019 ◽  
Author(s):  
Nushka Ubhayawardana ◽  
Manjula Weerasekera ◽  
Kamani Samarasinghe ◽  
Sameera Premalal ◽  
Deepaka Weerasekera ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Variable Number ◽  
Ulcer Disease ◽  
Chronic Active Gastritis ◽  
Sydney System ◽  
Histologic Lesion ◽  
Updated Sydney System ◽  
H Pylori

Abstract Objective Helicobacter pylori is a major cause for chronic gastritis and further it is associated with development of peptic ulcer disease and gastric cancer. Therefore, the objective of this study was to classify gastritis according to the updated Sydney system guidelines and find the association of H. pylori with each of graded variable. Number of 152 dyspeptic patients who underwent upper gastro-intestinal endoscopy at a Teaching Hospital were enrolled. Of the 2 biopsies collected one was used for PCR to detect H. pylori. The other biopsy was fixed in formalin followed by paraffin embedding and stained with H&E stain. Gastritis was classified microscopically according to the updated Sydney system. Results : Gastritis was reported over a wide age group ranging from 18-84 years with a mean age of 51 years. Based on histological findings, 12% of patients were diagnosed as H. pylori associated chronic active gastritis. There was no significant association between each graded variable and H. pylori positivity. Of the 152 dyspeptic patients 34 were positive by PCR for H. pylori infection. All the dyspeptic patients with H. pylori infection had chronic active gastritis, suggesting an etiologic role of the bacterium in the histologic lesion.

Inflammatory cell numbers in the stomach of Japanese subjects with endoscopically normal mucosa without H. pylori infection

2021 ◽  
Author(s):  
Naoki Sumi ◽  
Ken Haruma ◽  
Tomoari Kamada ◽  
Mitsuhiko Suehiro ◽  
Noriaki Manabe ◽  
...  
Keyword(s):  
Inflammatory Cells ◽  
Normal Mucosa ◽  
Mucosal Inflammation ◽  
Upper Gastrointestinal Endoscopy ◽  
Fundic Gland ◽  
Eosinophilic Gastritis ◽  
Pyloric Mucosa ◽  
Sydney System ◽  
Updated Sydney System ◽  
H Pylori

Introduction: Since inflammatory cells, such as lymphocytes and plasma cells, normally inhabit the stomach, the border between normal and mild inflammation is difficult to visually determine using the updated Sydney system scale of gastritis. Additionally, eosinophils in the gastric mucosa must be counted to diagnose eosinophilic gastritis. We aimed to determine the normal number of inflammatory cells in patients with endoscopically normal mucosa and without H. pylori infections. Methods: We assessed patients aged 20–79 years, who had undergone upper gastrointestinal endoscopy at Kawasaki Medical School Hospital between January 2010 and December 2014. Inflammatory cells were counted in 1,000 μm2 fields of pyloric and fundic gland mucosal biopsy specimens. We finally included 325 (male, n = 141; female, n = 184; average age = 49.3 years) patients without inflammation who had H. pylori-negative endoscopic results and negative histological findings interpreted based on the updated Sydney System and the Kyoto classification of gastritis. Results: The average numbers of nucleated cells were 83.3 ± 14.2/mm2 and 65.4 ± 12.6/mm2 in the pyloric and fundic gland mucosae, respectively. Inflammatory cells were significantly more abundant in the pyloric mucosa than the fundic gland mucosa (p < 0.05). Age and sex distribution did not significantly differ. Eosinophils were absent or scanty in the gastric mucosae of both glands in all patients. Conclusion: We determined the absolute values of inflammatory cells, including eosinophils, in normal mucosae of pyloric and fundic glands. These findings could be important in defining gastric mucosal inflammation, including eosinophilic gastritis diagnosis.

The Relationship Between Updated Sydney System Score and LDL Cholesterol Levels in Patients Infected with Helicobacter pylori

2008 ◽  
Vol 54 (3) ◽  
pp. 604-607 ◽  
Author(s):  
Metin Kucukazman ◽  
Bunyamin Yavuz ◽  
Muhammed Sacikara ◽  
Zeliha Asilturk ◽  
Naim Ata ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Ldl Cholesterol ◽  
Cholesterol Levels ◽  
Sydney System ◽  
Updated Sydney System ◽  
The Relationship

scholarly journals Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Tsachi Tsadok Perets ◽  
Hemda Schmilovitz-Weiss ◽  
Rachel Gingold-Belfer ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Treatment Success ◽  
Population Based ◽  
Urea Breath Test ◽  
First Line Therapy ◽  
13C Urea Breath Test ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

scholarly journals dupA as a risk determinant in Helicobacter pylori infection

2008 ◽  
Vol 57 (5) ◽  
pp. 554-562 ◽  
Author(s):  
Masoumeh Douraghi ◽  
Marjan Mohammadi ◽  
Akbar Oghalaie ◽  
Afshin Abdirad ◽  
Mohammad Ali Mohagheghi ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Univariate Analysis ◽  
Histopathological Changes ◽  
Disease Category ◽  
Specific Pcr ◽  
Sydney System ◽  
H Pylori

The Helicobacter pylori duodenal ulcer promoting (dupA) gene has been previously described as a risk marker for duodenal ulcer (DU) development and a protective factor against gastric cancer (GC). Recent studies which have assessed the application of dupA in the prediction of clinical outcomes have been controversial. In the current study, the association of dupA with the clinical outcomes and histopathological changes following H. pylori infection was evaluated in Iranian patients. A total of 157 H. pylori-infected patients with DU (n=30), gastric ulcer (n=23), gastritis (n=68) or GC (n=36) were assessed. The presence of jhp0917 and jhp0918 genes was determined by gene specific PCR. Gastric histopathological changes were recorded according to the updated Sydney system. Seventy-eight (49.7 %) and 71 (45.2 %) of the 157 tested strains, respectively, were positive and negative for both genes. The remaining 8 (5.09 %) of the 157 strains were jhp0917-positive/jhp0918-negative. Univariate analysis showed inverse associations between dupA and histological features including dysplasia as the penultimate stage of GC and lymphoid follicles as a consequence of relatively long-standing H. pylori-associated gastritis. The degrees of nucleotide sequence identity of Iranian strains to Colombian, Brazilian and Indian strains ranged from 86.1 to 100 % for the aligned regions of jhp0917, from 88  to 98.8 % for jhp0918 and from 93.4  to 99.5 % for the partial sequences of the dupA gene. Despite the fact that possession of the dupA gene showed no association with any disease category in our population as reported in several other countries, association of dupA-negative strains of H. pylori with pre-malignant lesions calls for additional studies to evaluate the role of this gene as a protective marker against GC.

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