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World J Meta-Anal. Jan 12, 2023; 11(1): 18-28
Published online Jan 12, 2023. doi: 10.13105/wjma.v11.i1.18
Cancer risk stratification system and classification of gastritis: Perspectives
Sergey M Kotelevets, Sergey A Chekh, Sergey Z Chukov
Sergey M Kotelevets, Department of Therapy, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
Sergey A Chekh, Department of Mathematics, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
Sergey Z Chukov, Department of Pathological Anatomy, Stavropol State Medical University, Stavropol 355017, Stavropol region, Russia
Author contributions: Kotelevets SM wrote the first part of the paper; Chekh SA wrote the second part of the paper; Chukov SZ wrote the third part of the paper.
Conflict-of-interest statement: All the author declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sergey M Kotelevets, MD, Associate Professor, Department of Therapy, North Caucasus State Academy, Lenina Street, 75/32, Cherkessk 369000, Karachay-Cherkess Republic, Russia. smkotelevets@mail.ru
Received: October 26, 2022
Peer-review started: October 26, 2022
First decision: November 16, 2022
Revised: November 17, 2022
Accepted: December 27, 2022
Article in press: December 27, 2022
Published online: January 12, 2023
Processing time: 76 Days and 15.4 Hours
Abstract

Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete. The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer, while mild to moderate atrophy has a low risk. The updated Kimura-Takemoto classification of atrophic gastritis considers five histological types of multifocal corpus atrophic gastritis according to stages C2 to O3. This method of morphological diagnosis of atrophic gastritis increases sensitivity by 2.4 times for severe atrophy compared to the updated Sydney system. This advantage should be considered when stratifying the high risk of gastric cancer. The updated Kimura-Takemoto classification of atrophic gastritis should be used as a reference standard (gold standard) in studies of morpho-functional relationships to identify serological markers of atrophic gastritis with evidence-based effectiveness. The use of artificial intelligence in the serological screening of atrophic gastritis makes it possible to screen a large number of the population. During serological screening of atrophic gastritis and risk stratification of gastric cancer, it is advisable to use the Kyoto classification of gastritis with updated Kimura-Takemoto classification of atrophic gastritis.

Keywords: Atrophic gastritis; Cancer risk stratification; Gastric cancer prevention; Classification of gastritis

Core Tip: Prevention of gastric cancer is an actual challenge of modern oncology. Its implementation is possible by means of serological screening of atrophic gastritis with accurate morphological diagnostics within the framework of the Kyoto classification of gastritis. If the Kyoto classification of gastritis is supplemented with the updated classification of Kimura-Takemoto atrophic gastritis, then it will be easier to estimate the risk of developing stomach cancer. The new system of gastric cancer risk stratification has the prospect of practical application in any population. For gastric cancer prevention at the level of large populations, we suggest using computer programs. The authors' computer program is given in this manuscript.