THERAPEUTIC RELEVANCE OF THE HISTOLOGICAL GASTRITIS CLASSIFICATION

The histological gastritis classification according to the Sydney syst em is a standardisation of different classification systems used so fa r. It is based on the principles of etiology, topography and course of the disease, as well as morphological changes of the gastric mucosa i n gastritis. Histological examination represents the practical gold st andard of Helicobacter pylori detection and can be used on routinely f ormaldehydefixed biopsy material and hematoxylin-eosin stained slides. Histology is therefore also of practical diagnostic value for the con trol of the eradication therapy of Helicobacter pylori. The sensitivit y of histological Helicobacter detection is on average higher than tha t of other methods including microbiology. Nevertheless, additional ba cterial cultures are useful in cases of therapy resistent Helicobacter pylori infections. For routine diagnosis histological Helicobacter py lori detection is often combined with the so-called rapid urease test, which can be used in the endoscopy outpatient department, frequently offering an interim diagnosis of Helicobacter pylori infection. Furthe rmore, histological examination enables not only exact gastritis class ification with Helicobacter pylori detection, but also the diagnosis o f precancerous lesions and gastric carcinomas, as well as primary gast ric lymphomas. Biopsy material for histological examination can be tak en during the routinely necessary gastroscopic examination of patients with gastric symptoms without much additional burden.