I.V. Maev, D.N. Andreev, A.A. Samsonov, D.T. Dicheva, E.V. Partsvania-Vinogradova

SBEI HPE MSMSU n.a. A.I. Evdokimov of RMPH, Moscow
In 2015, the Kyoto Consensus was conducted. It was aimed to the systematization of the data on the etiology, diagnostic tactics and treatment of inflammatory changes in the mucous membrane of the stomach and duodenum accumulated over the past few years. Expert council has widely discussed issues related to the updating of the current systems of classification of chronic gastritis, duodenitis, analyzed the role of this nosological units in the formation and progression of precancerous changes of the mucous membrane of the stomach, as well as the possibility of eradication therapy as a method of cancer prevention. Kyoto Consensus has played an important role in the modern understanding of the problem of inflammatory gastroduodenal pathology and identification the ways to resolve it. The Consensus statements concerned mostly the classification, diagnosis and treatment of H. pylori-associated gastritis.


  1. Маев И.В., Самсонов А.А., Андреев Д.Н. Болезни желудка. М., 2015, 976 с.
  2. Маев И.В., Самсонов А.А., Андреев Д.Н. Инфекция Helicobacter pylori. М., 2016. 256 с.
  3. Morgan D.R., Crowe S.E. Helicobacter pylori infection. In.: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Ed. by M. Feldman, L.S. Friedman, L.J. Brandt. 2015;856–84.
  4. Malfertheiner P., Link A., Selgrad M. Helicobacter pylori: perspectives and time trends. Nat. Rev. Gastroenterol. Hepatol. 2014;11(10):628–38.
  5. Malfertheiner P., Megraud F., O’Morain C., Atherton J., Axon A.T., Bazzoli F., Gensini G.F., Gisbert J.P., Graham D.Y., Rokkas T., El-Omar E.M., Kuipers E.J. Management of Helicobacter pylori infection – Maastricht IV. Florence Consensus Report. Gut. 2012;61:646–64.
  6. Sugano K., Tack J., Kuipers E.J., Graham D.Y., El-Omar E.M., Miura S., Haruma K., Asaka M., Uemura N., Malfertheiner P; faculty members of Kyoto Global Consensus Conference. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9):1353–67.
  7. Marshall B.J., Armstrong J.A., McGechie D.B., Glancy R.J. Attempt to fulfil Koch’s postulates for pyloric Campylobacter. Med. J. 1985;142:436–39.
  8. Morris A., Nicholson G. Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am. J. Gastroenterol. 1987;82:192–99.
  9. Meining A., Stolte M., Hatz R., Lehn N., Miehlke S., Morgner A., Bayerdörffer E. Differing degree and distribution of gastritis in Helicobacter pylori-associated diseases. Virchows Arch. 1997;431:11–5.
  10. Uemura N., Okamoto S., Yamamoto S., Matsumura N., Yamaguchi S., Yamakido M., Taniyama K., Sasaki N., Schlemper R.J. H. pylori infection and the development of gastric cancer. N. Engl. J. Med. 2001;345:784–89.
  11. El-Omar E.M., Oien K., El-Nujumi A., Gillen D., Wirz A., Dahill S., Williams C., Ardill J.E., McColl K.E. Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology. 1997;113:15–24.
  12. Malfertheiner P. The intriguing relationship of Helicobacter pylori infection and acid secretion in peptic ulcer disease and gastric cancer. Dig. Di. 2011;29:459–64.
  13. Correa P. Gastric cancer: overview. Gastroenterol. Clin. North. Am. 2013;42:211–17.
  14. Suerbaum S., Michetti P. Helicobacter pylori infection. N. Engl. J. Med. 2002;347(15):1175–86.
  15. Dinis-Ribeiro M., Areia M., de Vries A.C., et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy. 2012;44:74–94.
  16. Dixon M.F., Genta R.M., Yardley J.H., Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am. J. Surg. Pathol. 1996;20:1161–81.
  17. Naylor G.M., Gotoda T., Dixon M., Shimoda T., Gatta L., Owen R., Tompkins D., Axon A. Why does Japan have a high incidence of gastric cancer? Comparison of gastritis between UK and Japanese patients. Gut. 2006;55:1545–52.
  18. Capelle L.G., De Vries A.C., Haringsma J., Ter Borg F., de Vries R.A., Bruno M.J., van Dekken H., Meijer J., van Grieken N.C., Kuipers E.J. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest. Endosc. 2010;71:1150e8.
  19. Rugge M., Correa P., Di Mario F., El-Omar E., Fiocca R., Geboes K., Genta R.M., Graham D.Y., Hattori T., Malfertheiner P., Nakajima S., Sipponen P., Sung J., Weinstein W., Vieth M. OLGA staging for gastritis: a tutorial. Dig. Liv. Dis. 2008;40:650–58.
  20. Toljamo K., Niemela S., Karvonen A.L., Karttunen R., Karttunen T.J. Histopathology of gastric erosions. Association with etiological factors and chronicity. Helicobacter. 2011;16:444–51.
  21. Hart J., Hawkey C.J., Lanas A., Naesdal J., Talley N.J., Thomson A.B., Yeomans N.D. Predictors of gastroduodenal erosions in patients taking low-dose aspirin. Aliment. Pharmacol. Ther. 2010;31:143–49.
  22. Hawkey C.J., Wilson I., Naesdal J., Langström G., Swannell A.J., Yeomans N.D. Influence of sex and Helicobacter pylori on development and healing of gastroduodenal lesions in non-steroidal anti-inflammatory drug users. Gut. 2002;51:344–50.
  23. Sonnenberg A., Lash R.H., Genta R.M. A national study of Helicobacter pylori infection in gastric biopsy specimens. Gastroenterology. 2010;139:1894–901.
  24. Kusters J.G., van Vliet A.H., Kuipers E.J. Pathogenesis of Helicobacter pylori infection. Clin. Microbiol. Rev. 2006;19(3):449–90.
  25. Peek R.M., Crabtree J.E. Helicobacter infection and gastric neoplasia. J. Pathol. 2006;208:233–48.
  26. Rosenstock S., Kay L., Rosenstock C., Andersen L.P., Bonnevie O., Jorgensen T. Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes. Gut. 1997;41:169–76.
  27. Buckley M., O’Morain C. Prevalence of Helicobacter pylori in non-ulcer dyspepsia. Aliment Pharmacol. Ther. 1995;9(Suppl. 2):53–8.
  28. Graham D.Y., Opekun A.R., Osato M.S., El-Zimaity H.M., Lee C.K., Yamaoka Y., Qureshi W.A., Cadoz M., Monath T.P. Challenge model for Helicobacter pylori infection in human volunteers. Gut. 2004;53:1235–43.
  29. Bode G., Brenner H., Adler G., Rothenbacher D. Dyspeptic symptoms in middle-aged to old adults: the role of Helicobacter pylori infection and various demographic and lifestyle factors. J. Intern. Med. 2002;252:41–7.
  30. Moayyedi P., Soo S., Deeks J., Delaney B., Harris A., Innes M., Oakes R., Wilson S., Roalfe A., Bennett C., Forman D. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst. Rev. 2005;Issue 2:CD002096.
  31. Zhao B., Zhao J., Cheng W.F, Shi W.J., Liu W., Pan X.L., Zhang G.X. Efficacy of Helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up. J. Clin. Gastroenterol. 2014;48:241–47.
  32. Suzuki H., Moayyedi P. Helicobacter pylori infection in functional dyspepsia. Nat. Rev. Gastroenterol. Hepatol. 2013;10:168–74.
  33. Malfertheiner P., Mossner J., Fischbach W., Layer P., Leodolter A., Stolte M., Demleitner K., Fuchs W. Helicobacter pylori eradication is beneficial in the treatment of functional dyspepsia. Aliment. Pharmacol. Ther. 2003;18:615–25.
  34. Mazzoleni L.E., Sander G.B., Francesconi C.F., et al. Helicobacter pylori eradication in functional dyspepsia: HEROES trial. Arch. Intern. Med. 2011;171:1929–36.
  35. Tack J., Talley N.J., Camilleri M., Holtmann G., Hu P., Malagelada J.R., Stanghellini V. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–79.
  36. Ang T., Fock K.M., Teo E.K., Chan Y.H., Ng T.M., Chua T.S., Tan J.Y. Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study. J. Gastroenterol. 2006;41:647–53.
  37. Price A.B. The Sydney system: histological division. J. Gastroenterol. Hepatol. 1991;6:209–22.
  38. Anagnostopoulos G.K., Yao K., Kaye P., et al. High-resolution magnification endoscopy can reliably identify normal gastric mucosa, Helicobacter pylori-associated gastritis and gastric atrophy. Endoscopy. 2007;39:202–7.
  39. Uedo N., Ishihara R., Iishi H., Yamamoto S., Yamamoto S., Yamada T., Imanaka K., Takeuchi Y., Higashino K., Ishiguro S., Tatsuta M. A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy. 2006;38:819–24.
  40. Lim J.H., Kim N., Lee H.S., Choe G., Jo S.Y., Chon I., Choi C., Yoon H., Shin C.M., Park Y.S., Lee D.H., Jung H.C. Correlation between endoscopic and histological diagnoses of gastric intestinal metaplasia. Gut. Liver. 2013;7:41–50.
  41. Correa P. Human gastric carcinogenesis: A multistep and multifactorial process – First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992;52:6735–40.
  42. de Vries A.C., van Grieken N.C., Looman C.W., Casparie M.K., de Vries E., Meijer G.A., Kuipers E.J. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology. 2008;134:945–52.
  43. Rugge M., Kim J.G., Mahachai V., Miehlke S., Pennelli G., Russo V.M., Perng C.L., Chang F.Y., Tandon R.K., Singal D.K., Sung J.J., Valenzuela J.E., Realdi G., Dore M.P., Graham D.Y. OLGA gastritis staging in young adults and country-specific gastric cancer risk. Int. J. Surg. Pathol. 2008;16:150–54.
  44. Rugge M., Meggio A., Pennelli G., Piscioli F., Giacomelli L., De Pretis G., Graham D.Y. Gastritis staging in clinical practice: the OLGA staging system. Gut. 2007;l56:631–36.
  45. Rugge M., Fassan M., Pizzi M., Farinati F., Sturniolo G.C., Plebani M., Graham D.Y. Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment. World J. Gastroenterol. 2011;17:4596–601.
  46. Rugge M., de Boni M., Pennelli G., de Bona M., Giacomelli L., Fassan M., Basso D., Plebani M., Graham D.Y. Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study. Aliment. Pharmacol. Ther. 2010;31:1104–11.
  47. Kuipers E.J. In through the out door: serology for atrophic gastritis. Eur. J. Gastroenterol. Hepatol. 2003;15:877–79.
  48. Miki K. Gastric cancer screening by combined assay for serum anti-Helicobacter pylori IgG antibody and serum pepsinogen levels – «ABC method» Proc. Jpn. Acad. Ser. B. Phys. Biol. Sci. 2011;87(7):405–14.
  49. Watabe H., Mitsushima T., Yamaji Y., et al. Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–68.
  50. Ford A.C., Forman D., Hunt R.H., et al. Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials. BMJ. 2014;348:g3174.
  51. Take S., Mizuno M., Ishiki K., et al. Baseline gastric mucosal atrophy is a risk factor associated with the development of gastric cancer after Helicobacter pylori eradication therapy in patients with peptic ulcer diseases. J. Gastroenterol. 2007;42(Suppl. 7):21–7.
  52. Chen H.N., Wang Z., Li X., et al. Helicobacter pylori eradication cannot reduce the risk of Gastric Cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis. Gastric. Cancer Published Online First 2015.
  53. de Vries A.C., Kuipers E.J., Rauws E.A. Helicobacter pylori eradication and gastric cancer: when is the horse out of the barn? Am. J. Gastroenterol. 2009;104:1342–45.
  54. Zhang Y.Y., Xia H.H., Zhuang Z.H., Zhong J. Review article: ‘true’ re-infection of Helicobacter pylori after successful eradication-worldwide annual rates, risk factors and clinical implications. Aliment. Pharmacol. Ther. 2009;29:145–60.
  55. Lee Y.C., Chen T.H., Chiu H.M., Shun C.T., Chiang H., Liu T.Y., Wu M.S., Lin J.T. The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention. Gut. 2013;62:676–82.
  56. Vergara M., Catalan M., Gisbert J.P., Calvet X. Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users. Aliment. Pharmacol. Ther. 2005;21:1411–18.
  57. Hanada K., Graham D.Y. Helicobacter pylori and the molecular pathogenesis of intestinal-type gastric carcinoma. Expert Rev. Anticancer Ther. 2014;14:947–54.
  58. Graham D.Y. Helicobacter pylori Update: Gastric Cancer, Reliable Therapy, and Possible Benefi ts. Gastroenterology. 2015;148(4):719–31.
  59. Маев И.В., Кучерявый Ю.А., Андреев Д.Н., Баркалова Е.В. Эрадикационная терапия инфекции Helicobacter pylori: обзор мировых тенденций. Тер. архив. 2014;3 94–9.
  60. Maev I.V., Andreev D.N., Kucheryavyi Yu.A., Dicheva D.T. Host factors influencing the eradication rate of Helicobacter pylori. World Applied Sci J. 2014;30:134–40.
  61. Megraud F., Coenen S., Versporten A., Kist M., Lopez-Brea M., Hirschl A.M., Andersen L.P., Goossens H., Glupczynski Y. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut. 2013;62:34–42.
  62. Liou J.M., Chang C.Y., Chen M.J, et al. The Primary Resistance of Helicobacter pylori in Taiwan after the National Policy to Restrict Antibiotic Consumption and Its Relation to Virulence Factors-A Nationwide Study. PLoS One. 2015;10(5):e0124199.
  63. Graham D.Y., Lee Y.C., Wu M.S. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence. Clin. Gastroenterol. Hepatol. 2014;12:177–86.
  64. Wu J.Y., Liou J.M., Graham D.Y. Evidence-based recommendations for successful Helicobacter pylori treatment. Expert. Rev. Gastroenterol. Hepatol. 2014;8:21–8.
  65. International Agency for Research on Cancer. Helicobacter pylori eradication as a strategy for preventing gastric cancer. IARC Working Group Reports. 2014;8, WHO Press, World Health Organization, Geneva, Switzerland.
  66. Graham D.Y., Shiotani A. The time to eradicate gastric cancer is now. Gut. 2005;54:735–38.
  67. Miki K. Gastric cancer screening using the serum pepsinogen test method. Gastric. Cancer 2006;9:245–53.
  68. Dinis-Ribeiro M., Yamaki G., Miki K., Costa-Pereira A., Matsukawa M., Kurihara M. Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J. Med. Screen 2004;11:141–47.

About the Autors

Corresponding author: D.N. Andreev – Teaching Assistant at the Department of Propedeutics of Internal Diseases and Gastroenterology MSMSU n.a. A.I. Evdokimov of RMPH, Moscow; e-mail:

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