The endoscopic changes associated with gastric intestinal metaplasia can be graded using the Kyoto classification risk score.
Parameters:
(1) atrophy by the Kimura-Takemoto classification
(2) intestinal metaplasia (grayish white mucosa)
(3) enlargement of gastric folds
(4) nodularity (small, granulated pattern in the antrum)
(5) diffuse redness
Parameter
Finding
Points
atrophy
C-0 or C-1
0
C-2 or C-3
1
O-1, O-2, O-3
2
intestinal metaplasia
none
antrum
corpus
fold enlargement
< 5 mm width
>= 5 mm width
nodularity
absent
present
diffuse redness
minor
severe
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the more severe the changes and the greater the risk of gastric cancer.
Performance:
• The area under the ROC curve is 0.706.
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Specialty: Gastroenterology