[Semiquantitative histopathologic analysis of chronic gastritis: extension and grading score]

Three endoscopic systematic biopsies were obtained from 261 patients showing chronic gastritis. Histopathologic features of chronic gastritis were graded from 0 to 3 points according to the Sydney System. In addition, an extension and grading histopathologic score was applied. This score was obtained from the sum of qualified grades for each feature in all three samples. Inflammation, activity, atrophy, and intestinal metaplasia were predominantly grade 1 and H pylori density was predominantly grade 2. Only 2.6% of the sections without atrophy showed intestinal metaplasia, while 79.3% of the sections depicting grade 2-3 intestinal metaplasia showed moderate to severe atrophy. Inflammation was more severe in the antral lesser curvature and the more severe atrophy was present in the antrum than in the corpus mucosa. Sydney System and extension and grading histopathologic score showed more extensive activity in patients older than 45 years. A lower histopathologic score of H pylori was seen in these patients. The presence of H pylori was directly correlated with inflammation severity and inversely with atrophy. These results, in accordance with data shown in the literature, suggest that the Sydney System and the extension and grading histopathologic score can be applied to compare chronic gastritis features in different groups of patients.