HISTOLOGICAL ASSESSMENT OF THE SYDNEY CLASSIFICATION OF ENDOSCOPIC GASTRITIS

To determine the significance of the endoscopic classification of gast ritis proposed by a working party at the World Congress of Gastroenter ology in Sydney 1990, 167 patients undergoing upper alimentary endosco py were prospectively assessed by comprehensive endoscopic and histolo gical methods. Ninety eight patients had endoscopic mucosal changes of gastritis according to the Sydney classification. Twenty six (27%) of these had histologically normal biopsy specimens. This was not statis tically significantly different to the 26 (38%) of 69 with normal endo scopies whose biopsy specimens were histologically normal (chi 2=1.857 , p>0.1). Forty three (62.5%) patients with normal endoscopies had his tological gastritis. No histological counterpart was found for the mac roscopic appearances of the gastric mucosa said to show inflammation p roposed by the Sydney classification of gastritis. These findings conf irm the inappropriateness of an endoscopic diagnosis of gastritis and it is suggested such a term should be reserved for the histological fi ndings.