There are various ways to classify chronic gastritis. Before the advent of gastroscopy, the classification and diagnostic nomenclature of chronic gastritis was clinically confusing due to the lack of complete pathological specimens, effective and exact diagnostic tools, and differences in problematic thinking perspectives. With the development and updating of gastroscopy technology, especially since the clinical application of fiberoptic gastroscopy, the combination of direct speculation of the gastric mucosa and mucosal tissue biopsy has provided a more definitive method for the diagnosis and classification of chronic gastritis. There are many classification methods for chronic gastritis, and it is difficult to introduce them one by one. The five classification methods of Schindler, Wood, Whitehead, Bockus, Strickland and the classification method of the World Congress of Gastroenterology in Sydney are briefly introduced here.
(1) Schindler’s classification (1940).
Classifies chronic gastritis into primary and secondary categories. Those with unknown causes are primary, while those with combined gastric ulcers, gastric cancer, and those who have undergone gastric surgery are secondary. Primary cases are divided into superficial, atrophic and hypertrophic types. Regarding hypertrophic gastritis, the results of years of practice have not been confirmed by biopsy, so it is not commonly used.
(2) Wood’s classification (1949).
Using blind suction method to take mucosa, chronic gastritis was classified into three types.
① superficial type; ② atrophic type; ③ gastric atrophy.
(3) Whitehead’s classification (1972).
Chronic gastritis is classified according to three categories: type of mucosa, degree of lesion, and presence of chemosis.
(4) Bockus classification
This method is based on Whitehead’s classification, which indicates the site of gastritis and subdivides the pathological histological changes of gastric mucosa.
(5) Strickland’s classification.
This is only one classification of atrophic gastritis.Strickland et al. divided atrophic gastritis into two independent types, type A and type B, based mainly on serum immunological examination and distribution of lesions in the stomach.Type A gastritis lesions are mainly seen in the gastric body, with more diffuse distribution, accompanied by pernicious anemia and positive serum mural cell antibodies, called autoimmune gastritis.Type B gastritis lesions are mostly seen in the gastric sinus, with multi (6) The new gastritis is a simple atrophic gastritis, which is not accompanied by pernicious anemia and is more likely to be complicated by gastric cancer.
(6) New classification of gastritis – Sydney system.
At the 9th World Congress of Gastroenterology in August 1990, Misiewicz et al. proposed the Sydney system – a new classification of gastritis. This classification is composed of two parts: histology and endoscopy. Histology is centered on the site of the lesion and identifies 3 basic diagnoses.
①Acute gastritis ;
② Chronic gastritis;
③Specific types of gastritis.
The etiology and associated factors were prefixed and the histomorphological description was suffixed, and the degree of intestinal epithelial hyperplasia, activity of inflammation, inflammation, glandular atrophy and HP infection were given separately. The endoscopic component was based on the description of what was seen with the naked eye and differentiated the degree of lesions to determine the diagnosis of seven endoscopic gastritis, namely.
① erythema exudatum gastritis
②Flat erosive gastritis;
(iii) elevated erosive gastritis;
④Atrophic gastritis;
⑤ hemorrhagic gastritis;
(6) Reflux gastritis;
⑦Fold hypertrophic gastritis.