The Kimura-Takemoto classification describes the distribution of atrophy along the mucosal surface of the stomach. It can also be used to map the distribution of gastric intestinal metaplasia (GIM).
Examination: multiple gastric biopsies
Appearance of atrophic areas on endoscopy: mucosal pallor with loss of gastric folds and/or decreased vascularity
Patterns:
(1) closed (C): gastric atrophy involving the antrum with extension to the proximal region of the corpus
(2) open (O): gastric atrophy involving a wider area with extension to the anterior wall, posterior wall and cardia
Subpatterns in bands along the long greater curvature:
(1) C1: distal most, near pylorus
(2) C2
(3) C3
(4) O1
(5) O2
(6) O3: most proximal, near cardia
Advanced gastric neoplasia and dysplasia progression is associated with the open-type pattern of atrophy.
The closed-type pattern of atrophy and absence of atrophy had very low rate of dysplasia or progression.
