| [ Summary ] |
A variety of heterogeneous disease entities such as gastroesophageal reflux disease (GERD), functional dyspepsia and macroscopic and/or histological gastritis are included under the category of "chronic gastritis", used for reimbursement in daily clinical practice. In addition to this abuse, no unified agreement has been reached by academic societies. For instance, endoscopists classify chronic gastritis according to macroscopic findings such as erythema, erosion, atrophy, and intestinal metaplasia, while the diagnosis by pathologists is based on histological findings such as inflammatory infiltration, gland atrophy, and intestinal metaplasia. The discordance between macroscopic and microscopic findings and diagnosis is well known and despite efforts to reconcile the discrepancy, no unanimous agreement has been reached.
In 1982, identification of Helicobacter pylori (H.pylori) by Warren and Marshal has revolutionized the whole concept of chronic gastritis. The concept that H.pylori infection is a major etiologic factor associated with chronic gastritis has been well established. Subsequently, a number of epidemiological observations, as well as experiments with animal models, have indicated that chronic gastritis, due to H.pylori, is a predisposing condition for gastric malignancies such as mucosa associated lymphoid tissue lymphoma and cancer. These conceptual changes have brought about new ideas for classifying chronic gastritis based on etiology, because they help implement therapeutic optimization of chronic gastritis treatment, most importantly, eradication therapy for H.pylori-positive gastritis. Further research by clinicians and pathologists and efforts to reach consensus on the etiology based classification of chronic gastritis should continued both by clinicians and pathologists. |