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Atrophic gastritis: pathology and endoscopy in the reversibility assessment
  1. M Rugge1,
  2. M Cassaro1,
  3. G Pennelli1,
  4. G Leandro2,
  5. F Di Mario3,
  6. F Farinati4
  1. 1Dipartimento di Scienze Oncologiche and Chirurgiche, Università degli Studi di Padova, Italia
  2. 2Ospedale G De Bellis, Castellana Grotte-Bari, Italia
  3. 3Dipartimento di Gastroenterologia, Università di Parma, Italia
  4. 4Dipartimento di Scienze Chirurgiche and Gastroenterologiche, Università degli Studi di Padova, Italia
  1. Correspondence to:
    M Rugge;
    massimo.rugge{at}unipd.it

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We read with interest the paper by Walker (Gut 2003;52:1–4). We agree that histology remains the most suitable test for both detecting and assessing reversion of atrophic gastritis. Such a view elicits two basic questions, however: (1) how consistent are pathologists in recognising gastric atrophy? and (2) in Walker’s words, “where to biopsy?” and, we might add, “how extensively to biopsy”, to correctly evaluate any presence/regression of gastric atrophy?

Concerning the first point on the classification of atrophic gastritis, the current literature is largely biased by the inconsistency of the histological criteria used to categorise atrophy.1,2 To amalgamate the different viewpoints and also test interobserver agreement in atrophy classification/scoring, an international group of …

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