British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma

Matthew Banks, David Graham, Marnix Jansen, Takuji Gotoda, Sergio Coda, Massimiliano di Pietro, Noriya Uedo, Pradeep Bhandari, D Mark Pritchard, Ernst J Kuipers, Manuel Rodriguez-Justo, Marco R Novelli, Krish Ragunath, Neil Shepherd, Mario Dinis-Ribeiro, Matthew Banks, David Graham, Marnix Jansen, Takuji Gotoda, Sergio Coda, Massimiliano di Pietro, Noriya Uedo, Pradeep Bhandari, D Mark Pritchard, Ernst J Kuipers, Manuel Rodriguez-Justo, Marco R Novelli, Krish Ragunath, Neil Shepherd, Mario Dinis-Ribeiro

Abstract

Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer-in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met.

Keywords: endoscopy; gastric adenocarcinoma; gastric pre-cancer; gastritis; helicobacter pylori-gastritis.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
(A) British Society of Gastroenterology (BSG) guidelines for the endoscopic management of chronic atrophic gastritis. (B) BSG guidelines for the endoscopic management of gastric dysplasia. (C) BSG guidelines for the endoscopic management of gastric epithelial polyps. CAG, chronic atrophic gastritis; FAP, familial adenomatous polyposis; FGP, fundic gland polyp; GIM, gastric intestinal metaplasia.
Figure 2
Figure 2
Systematic screening protocol for the stomach. This is a station-based approach whereby each area of the stomach is viewed and photographed in either a clockwise or counterclockwise manner. The 22 pictures are arranged according to the order of the procedure. Q, quadrant; L, lesser curvature; A, anterior wall; G, greater curvature; P, posterior wall; SSS, systematic screening protocol for the somach.
Figure 3
Figure 3
Normal gastric corpus and antrum mucosal surface pattern with white light, enhanced and magnification endoscopy. The round ‘pit patterns’ of the corpus (Ai) and elongated ‘pit patterns’ of the antrum (Di) can be seen without magnification or enhancement. In the corpus (Ai), the red collecting venules (CV) are evident as well as the round dark red crypt openings (CO). The vascular anatomy becomes more pronounced with NBI (Aii & Dii). The visible anatomical components seen on magnification NBI include the dark brown ‘crypt openings’ (CO), the dark brown sub-epithelial capillary network (SECN), and the light brown marginal crypt epithelia (MCE). The corpus mucosa has dark round ‘crypt openings’, surrounded by the lighter MCE, followed by the darker circular SECN (Aii & Aiii). In contrast, the dark, oblique ‘crypt openings’ in the antrum are grooved so the light coloured ridged or villiform epithelium (MCE) surrounds the dark SECN, termed the ‘groove type pattern’ (Dii & Diii). The corresponding histopathological architecture can be seen in the corpus (B and C) and in the antrum (E and F).
Figure 4
Figure 4
Chronic atrophic gastritis (CAG) and the atrophic border on white light and image enhanced endoscopy. There are four principle endoscopic features of CAG: palor (A, B, C, D and E), loss of gastric folds (A, B, C, D and E), prominence of the vessels (A, B, C and D) and the atrophic border (A and B). The paler areas of atrophy are also clear on image enhancement (F).
Figure 5
Figure 5
The Integrated and Modified Kimura & Sydney Biopsy System. The modified Kimura staging system divides the extent of atrophy into antrum only (antral), antrum to incisura (antral dominant), antrum to lesser curve (corpus dominant), and antrum, lesser curve and greater curve (pan-atrophy). This system integrates Sydney protocol biopsies which should be taken from the antrum (site 1 and 2), incisura (site 3), lesser curve (site 4) and greater curve (site 5). The anatomical CAG boundaries and biopsy sites can be seen in the splayed (A) and cross-sectional cartoon (B) of the stomach. The biopsy sites defined in the endoscopic retroflexed (C) and forward view (D).
Figure 6
Figure 6
Gastric intestinal metaplasia under white light, image enhanced and magnification endoscopy. Intestinal metaplasia typically appears as small grey-white slightly elevated plaques surrounded by mixed patchy pink and pale areas of mucosa causing an irregular uneven surface (A). These appearances are more evident with image enhancement (B). Corpus GIM can be distinguished from the normal straight/tubular glands of the corpus by a ‘groove type pattern’ similar to that of the antrum or villiform pattern of the intestine and may be appreciated with higher resolution technology on white light endoscopy (C). GIM in the antrum is more difficult to characterize as the normal glands are oblique. Additional features of GIM to aid diagnosis in the antrum include the light blue crest (LBC) and the marginal turbid band (MTB) (D). The LBC is a fine, blue-white line on the crest of the epithelial surface seen with NBI enhancement (Fine arrows in D). The MTD can be seen between the broad arrows. The numerous goblet cells characterise GIM (E & F).
Figure 7
Figure 7
Fundic glandular and hyperplastic polyps. A) Fundic glandular polyps seen in the corpus and body. They are either lighter or the same colour as the surrounding mucosa. B) On near view, with image enhancement, lacy blood vessels are seen through the translucent surface and the surface shows a pattern of fine grey dots. C) Hyperplastic polyps are smooth, red buttered with whitish exudates (fibrin) and are dome shaped. The surface vascular pattern is more prominent on image enhancement (D).

References

    1. Amiri M, Janssen F, Kunst AE. The decline in stomach cancer mortality: exploration of future trends in seven European countries. Eur J Epidemiol 2011;26:23–8. 10.1007/s10654-010-9522-9
    1. Rahman R, Asombang AW, Ibdah JA. Characteristics of gastric cancer in Asia. World J Gastroenterol 2014;20:4483–90. 10.3748/wjg.v20.i16.4483
    1. Cancer Research UK. Stomach cancer statistics | Cancer Research UK [Internet]. 2016. (cited 14 Mar 2018).
    1. Song H, Held M, Sandin S, et al. . Increase in the prevalence of atrophic gastritis among adults age 35 to 44 years old in northern Sweden between 1990 and 2009. Clin Gastroenterol Hepatol 2015;13:1592–600. 10.1016/j.cgh.2015.04.001
    1. Anderson WF, Camargo MC, Fraumeni JF, et al. . Age-specific trends in incidence of noncardia gastric cancer in US adults. JAMA 2010;303:1723–8. 10.1001/jama.2010.496
    1. Maconi G, Manes G, Porro GB. Role of symptoms in diagnosis and outcome of gastric cancer. World J Gastroenterol 2008;14:1149–55. 10.3748/wjg.14.1149
    1. Matsuda T, Saika K. The 5-year relative survival rate of stomach cancer in the USA, Europe and Japan. Jpn J Clin Oncol 2013;43:1157–8. 10.1093/jjco/hyt166
    1. Correa P, Haenszel W, Cuello C, et al. . A model for gastric cancer epidemiology. Lancet 1975;2:58–60. 10.1016/S0140-6736(75)90498-5
    1. Correa P. A human model of gastric carcinogenesis. Cancer Res 1988;48:3554–60.
    1. Dinis-Ribeiro M, Areia M, de Vries AC, 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. 10.1055/s-0031-1291491
    1. Tham TC, Gleeson D, Greenfield SM, et al. . British Society of Gastroenterology policy and processes for the development of guidelines. Gut 2015;64:1184–5. 10.1136/gutjnl-2015-309164
    1. Appraisal of guidelines for research & evaluation II. The AGREE Research Trust. Update: September 2013 .
    1. Spence AD, Cardwell CR, McMenamin ÚC, et al. . Adenocarcinoma risk in gastric atrophy and intestinal metaplasia: a systematic review. BMC Gastroenterol 2017;17:157 10.1186/s12876-017-0708-4
    1. Guyatt GH, Oxman AD, Vist GE, et al. . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–6. 10.1136/
    1. Song H, Ekheden IG, Zheng Z, et al. . Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population. BMJ 2015;351:h3867 10.1136/bmj.h3867
    1. Miwata T, Quach DT, Hiyama T, et al. . Interobserver and intraobserver agreement for gastric mucosa atrophy. BMC Gastroenterol 2015;15:95 10.1186/s12876-015-0327-x
    1. Leja M, Funka K, Janciauskas D, et al. . Interobserver variation in assessment of gastric premalignant lesions: higher agreement for intestinal metaplasia than for atrophy. Eur J Gastroenterol Hepatol 2013;25:694–9. 10.1097/MEG.0b013e32835e3397
    1. Toyoshima O, Yamaji Y, Yoshida S, et al. . Endoscopic gastric atrophy is strongly associated with gastric cancer development after Helicobacter pylori eradication. Surg Endosc 2017;31:2140–8. 10.1007/s00464-016-5211-4
    1. Webb PM, Hengels KJ, Møller H, et al. . The epidemiology of low serum pepsinogen A levels and an international association with gastric cancer rates. EUROGAST Study Group. Gastroenterology 1994;107:1335–44. 10.1016/0016-5085(94)90535-5
    1. Weck MN. Prevalence of chronic atrophic gastritis in different parts of the world. Cancer Epidemiol Biomarkers Prev 2006;15:1083–94. 10.1158/1055-9965.EPI-05-0931
    1. Choi CE, Sonnenberg A, Turner K, et al. . High prevalence of gastric preneoplastic lesions in East Asians and Hispanics in the USA. Dig Dis Sci 2015;60:2070–6. 10.1007/s10620-015-3591-2
    1. Namekata T, Miki K, Kimmey M, et al. . Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle. Am J Epidemiol 2000;151:820–30. 10.1093/oxfordjournals.aje.a010282
    1. Adamu MA, Weck MN, Gao L, et al. . Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies. Eur J Epidemiol 2010;25:439–48. 10.1007/s10654-010-9482-0
    1. Vannella L, Lahner E, Annibale B. Risk for gastric neoplasias in patients with chronic atrophic gastritis: a critical reappraisal. World J Gastroenterol 2012;18:1279–85. 10.3748/wjg.v18.i12.1279
    1. de Vries AC, van Grieken NC, Looman CW, et al. . Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology 2008;134:945–52. 10.1053/j.gastro.2008.01.071
    1. Shichijo S, Hirata Y, Niikura R, et al. . Histologic intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication. Gastrointest Endosc 2016;84:618–24. 10.1016/j.gie.2016.03.791
    1. Eriksson NK, Kärkkäinen PA, Färkkilä MA, et al. . Prevalence and distribution of gastric intestinal metaplasia and its subtypes. Dig Liver Dis 2008;40:355–60. 10.1016/j.dld.2007.12.012
    1. Olmez S, Aslan M, Erten R, et al. . The prevalence of gastric intestinal metaplasia and distribution of Helicobacter pylori infection, atrophy, dysplasia, and cancer in its subtypes. Gastroenterol Res Pract 2015;2015:1–6. 10.1155/2015/434039
    1. Eidt S, Stolte M. Prevalence of intestinal metaplasia in Helicobacter pylori gastritis. Scand J Gastroenterol 1994;29:607–10. 10.3109/00365529409092480
    1. Tulassay Z, Stolte M, Engstrand L, et al. . Twelve-month endoscopic and histological analysis following proton-pump inhibitor-based triple therapy in Helicobacter pylori-positive patients with gastric ulcers. Scand J Gastroenterol 2010;45:1048–58. 10.3109/00365520903575737
    1. Uemura N, Okamoto S, Yamamoto S, et al. . Helicobacter pylori infection and the development of gastric cancer. N Engl J Med Overseas Ed 2001;345:784–9. 10.1056/NEJMoa001999
    1. Zullo A, Hassan C, Romiti A, et al. . Follow-up of intestinal metaplasia in the stomach: when, how and why. World J Gastrointest Oncol 2012;4:30–6. 10.4251/wjgo.v4.i3.30
    1. Park YH, Kim N. Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev 2015;20:25–40. 10.15430/JCP.2015.20.1.25
    1. González CA, Sanz-Anquela JM, Companioni O, et al. . Incomplete type of intestinal metaplasia has the highest risk to progress to gastric cancer: results of the Spanish follow-up multicenter study. J Gastroenterol Hepatol 2016;31:953–8. 10.1111/jgh.13249
    1. Dinis-Ribeiro M, Lopes C, da Costa-Pereira A, et al. . A follow up model for patients with atrophic chronic gastritis and intestinal metaplasia. J Clin Pathol 2004;57:177–82. 10.1136/jcp.2003.11270
    1. Cassaro M, Rugge M, Gutierrez O, et al. . Topographic patterns of intestinal metaplasia and gastric cancer. Am J Gastroenterol 2000;95:1431–8. 10.1111/j.1572-0241.2000.02074.x
    1. Vannella L, Lahner E, Osborn J, et al. . Risk factors for progression to gastric neoplastic lesions in patients with atrophic gastritis. Aliment Pharmacol Ther 2010;31:1042–50. 10.1111/j.1365-2036.2010.04268.x
    1. Lahner E, Bordi C, Cattaruzza MS, et al. . Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection. Aliment Pharmacol Ther 2005;22:471–81. 10.1111/j.1365-2036.2005.02582.x
    1. Rugge M, Fassan M, Pizzi M, et al. . Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment. World J Gastroenterol 2011;17:4596–601. 10.3748/wjg.v17.i41.4596
    1. Capelle LG, de Vries AC, Haringsma J, et al. . The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc 2010;71:1150–8. 10.1016/j.gie.2009.12.029
    1. Weston AP, Krmpotich P, Makdisi WF, et al. . Short segment Barrett’s esophagus: clinical and histological features, associated endoscopic findings, and association with gastric intestinal metaplasia. Am J Gastroenterol 1996;91:981–6.
    1. Johnston MH, Hammond AS, Laskin W, et al. . The prevalence and clinical characteristics of short segments of specialized intestinal metaplasia in the distal esophagus on routine endoscopy. Am J Gastroenterol 1996;91:1507–11.
    1. Sharma P, Weston AP, Morales T, et al. . Relative risk of dysplasia for patients with intestinal metaplasia in the distal oesophagus and in the gastric cardia. Gut 2000;46:9–13. 10.1136/gut.46.1.9
    1. Sung JK. Diagnosis and management of gastric dysplasia. Korean J Intern Med 2016;31:201–9. 10.3904/kjim.2016.021
    1. Lauwers GY, Riddell RH. Gastric epithelial dysplasia. Gut 1999;45:784 10.1136/gut.45.5.784
    1. Kim JW, Jang JY. Optimal management of biopsy-proven low-grade gastric dysplasia. World J Gastrointest Endosc 2015;7:396–402. 10.4253/wjge.v7.i4.396
    1. Baek DH, Kim GH, Park DY, et al. . Gastric epithelial dysplasia: characteristics and long-term follow-up results after endoscopic resection according to morphological categorization. BMC Gastroenterol 2015;15:17 10.1186/s12876-015-0249-7
    1. Shin CM, Kim N, Yang HJ, et al. . Stomach cancer risk in gastric cancer relatives: interaction between Helicobacter pylori infection and family history of gastric cancer for the risk of stomach cancer. J Clin Gastroenterol 2010;44:e34–9. 10.1097/MCG.0b013e3181a159c4
    1. Lissowska J, Groves FD, Sobin LH, et al. . Family history and risk of stomach cancer in Warsaw, Poland. Eur J Cancer Prev 1999;8:223–7. 10.1097/00008469-199906000-00010
    1. Nagase H, Ogino K, Yoshida I, et al. . Family history-related risk of gastric cancer in Japan: a hospital-based case-control study. Jpn J Cancer Res 1996;87:1025–8. 10.1111/j.1349-7006.1996.tb03104.x
    1. Jiang X, Tseng CC, Bernstein L, et al. . Family history of cancer and gastroesophageal disorders and risk of esophageal and gastric adenocarcinomas: a case-control study. BMC Cancer 2014;14:60 10.1186/1471-2407-14-60
    1. Kwak HW, Choi IJ, Kim CG, et al. . Individual having a parent with early-onset gastric cancer may need screening at younger age. World J Gastroenterol 2015;21:4592–8. 10.3748/wjg.v21.i15.4592
    1. Reddy KM, Chang JI, Shi JM, et al. . Risk of gastric cancer among patients with intestinal metaplasia of the stomach in a US integrated health care system. Clin Gastroenterol Hepatol 2016;14:1420–5. 10.1016/j.cgh.2016.05.045
    1. Lichtenstein P, Holm NV, Verkasalo PK, et al. . Environmental and heritable factors in the causation of cancer — analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med Overseas Ed 2000;343:78–85. 10.1056/NEJM200007133430201
    1. Oliveira C, Pinheiro H, Figueiredo J, et al. . Familial gastric cancer: genetic susceptibility, pathology, and implications for management. Lancet Oncol 2015;16:e60–e70. 10.1016/S1470-2045(14)71016-2
    1. Rudloff U. Gastric adenocarcinoma and proximal polyposis of the stomach: diagnosis and clinical perspectives. Clin Exp Gastroenterol 2018;11:447–59. 10.2147/CEG.S163227
    1. Repak R, Kohoutova D, Podhola M, et al. . The first European family with gastric adenocarcinoma and proximal polyposis of the stomach: case report and review of the literature. Gastrointest Endosc 2016;84:718–25. 10.1016/j.gie.2016.06.023
    1. Capelle LG, Van Grieken NC, Lingsma HF, et al. . Risk and epidemiological time trends of gastric cancer in Lynch syndrome carriers in the Netherlands. Gastroenterology 2010;138:487–92. 10.1053/j.gastro.2009.10.051
    1. Heald B, Mester J, Rybicki L, et al. . Frequent gastrointestinal polyps and colorectal adenocarcinomas in a prospective series of PTEN mutation carriers. Gastroenterology 2010;139:1927–33. 10.1053/j.gastro.2010.06.061
    1. Syngal S, Brand RE, Church JM, et al. . ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol 2015;110:223–62. 10.1038/ajg.2014.435
    1. Kluijt I, Sijmons RH, Hoogerbrugge N, et al. . Familial gastric cancer: guidelines for diagnosis, treatment and periodic surveillance. Fam Cancer 2012;11:363–9. 10.1007/s10689-012-9521-y
    1. van der Post RS, Vogelaar IP, Carneiro F, et al. . Hereditary diffuse gastric cancer: updated clinical guidelines with an emphasis on germline CDH1 mutation carriers. J Med Genet 2015;52:361–74. 10.1136/jmedgenet-2015-103094
    1. Fitzgerald RC, Hardwick R, Huntsman D, et al. . Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research. J Med Genet 2010;47:436–44. 10.1136/jmg.2009.074237
    1. Persson C, Canedo P, Machado JC, et al. . Polymorphisms in inflammatory response genes and their association with gastric cancer: a HuGE systematic review and meta-analyses. Am J Epidemiol 2011;173:259–70. 10.1093/aje/kwq370
    1. Vannella L, Lahner E, Osborn J, et al. . Systematic review: gastric cancer incidence in pernicious anaemia. Aliment Pharmacol Ther 2013;37:375–82. 10.1111/apt.12177
    1. Murphy G, Dawsey SM, Engels EA, et al. . Cancer risk after pernicious anemia in the US elderly population. Clin Gastroenterol Hepatol 2015;13:2282–9. 10.1016/j.cgh.2015.05.040
    1. Rusak E, Chobot A, Krzywicka A, et al. . Anti-parietal cell antibodies - diagnostic significance. Adv Med Sci 2016;61:175–9. 10.1016/j.advms.2015.12.004
    1. Minalyan A, Benhammou JN, Artashesyan A, et al. . Autoimmune atrophic gastritis: current perspectives. Clin Exp Gastroenterol 2017;10:19–27. 10.2147/CEG.S109123
    1. Fisher SG, Davis F, Nelson R, et al. . A cohort study of stomach cancer risk in men after gastric surgery for benign disease. J Natl Cancer Inst 1993;85:1303–10. 10.1093/jnci/85.16.1303
    1. Tersmette AC, Goodman SN, Offerhaus GJ, et al. . Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients. Am J Epidemiol 1991;134:14–21. 10.1093/oxfordjournals.aje.a115988
    1. Viste A, Bjørnestad E, Opheim P, et al. . Risk of carcinoma following gastric operations for benign disease. A historical cohort study of 3470 patients. Lancet 1986;2:502–5.
    1. Schafer LW, Larson DE, Melton LJ, et al. . The risk of gastric carcinoma after surgical treatment for benign ulcer disease. A population-based study in Olmsted County, Minnesota. N Engl J Med 1983;309:1210–3. 10.1056/NEJM198311173092003
    1. Lagergren J, Lindam A, Mason RM. Gastric stump cancer after distal gastrectomy for benign gastric ulcer in a population-based study. Int J Cancer 2012;131:E1048–E1052. 10.1002/ijc.27614
    1. Jemal A, Siegel R, Ward E, et al. . Cancer statistics, 2006. CA Cancer J Clin 2006;56:106–30. 10.3322/canjclin.56.2.106
    1. Ali R, Barnes I, Cairns BJ, et al. . Incidence of gastrointestinal cancers by ethnic group in England, 2001-2007. Gut 2013;62:1692–703. 10.1136/gutjnl-2012-303000
    1. Lui FH, Tuan B, Swenson SL, et al. . Ethnic disparities in gastric cancer incidence and survival in the USA: an updated analysis of 1992-2009 SEER data. Dig Dis Sci 2014;59:3027–34. 10.1007/s10620-014-3275-3
    1. Jin H, Pinheiro PS, Xu J, et al. . Cancer incidence among Asian American populations in the United States, 2009-2011. Int J Cancer 2016;138:2136–45. 10.1002/ijc.29958
    1. Dong E, Duan L, Wu BU. Racial and ethnic minorities at increased risk for gastric cancer in a regional US population study. Clin Gastroenterol Hepatol 2017;15:511–7. 10.1016/j.cgh.2016.11.033
    1. Pérez-Rodríguez M, Partida-Rodríguez O, Camorlinga-Ponce M, et al. . Polymorphisms in HLA-DQ genes, together with age, sex, and Helicobacter pylori infection, as potential biomarkers for the early diagnosis of gastric cancer. Helicobacter 2017;22:e12326 10.1111/hel.12326
    1. Lee TY, Wang RC, Lee YC, et al. . The incidence of gastric adenocarcinoma among patients with gastric intestinal metaplasia: a long-term cohort study. J Clin Gastroenterol 2016;50:532–7. 10.1097/MCG.0000000000000406
    1. Leung WK, Lin SR, Ching JY, et al. . Factors predicting progression of gastric intestinal metaplasia: results of a randomised trial on Helicobacter pylori eradication. Gut 2004;53:1244–9. 10.1136/gut.2003.034629
    1. You WC, Li JY, Blot WJ, et al. . Evolution of precancerous lesions in a rural Chinese population at high risk of gastric cancer. Int J Cancer 1999;83:615–9. 10.1002/(SICI)1097-0215(19991126)83:5<615::AID-IJC8>;2-L
    1. Theuer CP, de Virgilio C, Keese G, et al. . Gastric adenocarcinoma in patients 40 years of age or younger. Am J Surg 1996;172:473–7. 10.1016/S0002-9610(96)00223-1
    1. Engel LS, Chow WH, Vaughan TL, et al. . Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst 2003;95:1404–13. 10.1093/jnci/djg047
    1. Sjödahl K, Lu Y, Nilsen TI, et al. . Smoking and alcohol drinking in relation to risk of gastric cancer: a population-based, prospective cohort study. Int J Cancer 2007;120:128–32. 10.1002/ijc.22157
    1. Nomura AMY, Wilkens LR, Henderson BE, et al. . The association of cigarette smoking with gastric cancer: the multiethnic cohort study. Cancer Causes Control 2012;23:51–8. 10.1007/s10552-011-9854-0
    1. Morais S, Rodrigues S, Amorim L, et al. . Tobacco smoking and intestinal metaplasia: systematic review and meta-analysis. Dig Liver Dis 2014;46:1031–7. 10.1016/j.dld.2014.08.034
    1. Song H, Zhu J, Lu D. Long-term proton pump inhibitor (PPI) use and the development of gastric pre-malignant lesions. Cochrane Database Syst Rev 2014;12:CD010623 10.1002/14651858.CD010623.pub2
    1. Ge Z, Ben Q, Qian J, et al. . Diabetes mellitus and risk of gastric cancer: a systematic review and meta-analysis of observational studies. Eur J Gastroenterol Hepatol 2011;23:1127–35. 10.1097/MEG.0b013e32834b8d73
    1. Tramacere I, Negri E, Pelucchi C, et al. . A meta-analysis on alcohol drinking and gastric cancer risk. Ann Oncol 2012;23:28–36. 10.1093/annonc/mdr135
    1. Lin XJ, Wang CP, Liu XD, et al. . Body mass index and risk of gastric cancer: a meta-analysis. Jpn J Clin Oncol 2014;44:783–91. 10.1093/jjco/hyu082
    1. Brusselaers N, Wahlin K, Engstrand L, et al. . Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden. BMJ Open 2017;7:e017739 10.1136/bmjopen-2017-017739
    1. Cheung KS, Chan EW, Wong AYS, et al. . Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study. Gut 2018;67:28–35. 10.1136/gutjnl-2017-314605
    1. Schneider JL, Kolitsopoulos F, Corley DA. Risk of gastric cancer, gastrointestinal cancers and other cancers: a comparison of treatment with pantoprazole and other proton pump inhibitors. Aliment Pharmacol Ther 2016;43:73–82. 10.1111/apt.13450
    1. BSG Position Statement - Proton pump inhibitors (PPIs) and the risk of gastric cancer [Internet]. (cited 27 Jan 2019).
    1. Cai X, Carlson J, Stoicov C, et al. . Helicobacter felis eradication restores normal architecture and inhibits gastric cancer progression in C57BL/6 mice. Gastroenterology 2005;128:1937–52. 10.1053/j.gastro.2005.02.066
    1. Lee CW, Rickman B, Rogers AB, et al. . Helicobacter pylori eradication prevents progression of gastric cancer in hypergastrinemic INS-GAS mice. Cancer Res 2008;68:3540–8. 10.1158/0008-5472.CAN-07-6786
    1. Ford AC, Forman D, Hunt RH, 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 10.1136/bmj.g3174
    1. Ford AC, Forman D, Hunt R, et al. . Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev 2015;7:CD005583.
    1. Doorakkers E, Lagergren J, Engstrand L, et al. . Eradication of Helicobacter pylori and gastric cancer: a systematic review and meta-analysis of cohort studies. J Natl Cancer Inst 2016;108:djw132 10.1093/jnci/djw132
    1. Lee YC, Chiang TH, Chou CK, et al. . Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology 2016;150:1113–24. 10.1053/j.gastro.2016.01.028
    1. O’Connor A, O’Morain CA, Ford AC. Population screening and treatment of Helicobacter pylori infection. Nat Rev Gastroenterol Hepatol 2017;14:230–40. 10.1038/nrgastro.2016.195
    1. Pan KF, Zhang L, Gerhard M, et al. . A large randomised controlled intervention trial to prevent gastric cancer by eradication of Helicobacter pylori in Linqu County, China: baseline results and factors affecting the eradication. Gut 2016;65:9–18. 10.1136/gutjnl-2015-309197
    1. Chen HN, 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 2016;19:166–75. 10.1007/s10120-015-0462-7
    1. Rokkas T, Rokka A, Portincasa P. A systematic review and meta-analysis of the role of Helicobacter pylori eradication in preventing gastric cancer. Ann Gastroenterol 2017;30:414–23. 10.20524/aog.2017.0144
    1. Choi IJ, Kook M-C, Kim Y-I, et al. . Helicobacter pylori therapy for the prevention of metachronous gastric cancer. N Engl J Med Overseas Ed 2018;378:1085–95. 10.1056/NEJMoa1708423
    1. Goddard AF, Badreldin R, Pritchard DM, et al. . British Society of Gastroenterology. The management of gastric polyps. Gut 2010;59:1270–6.
    1. Ohkusa T, Miwa H, Hojo M, et al. . Endoscopic, histological and serologic findings of gastric hyperplastic polyps after eradication of Helicobacter pylori: comparison between responder and non-responder cases. Digestion 2003;68:57–62. 10.1159/000074516
    1. Ohkusa T, Takashimizu I, Fujiki K, et al. . Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial. Ann Intern Med 1998;129:712–5.
    1. Ji F, Wang ZW, Ning JW, et al. . Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: a randomized, controlled trial. World J Gastroenterol 2006;12:1770–3. 10.3748/wjg.v12.i11.1770
    1. Ljubicić N, Banić M, Kujundzić M, et al. . The effect of eradicating Helicobacter pylori infection on the course of adenomatous and hyperplastic gastric polyps. Eur J Gastroenterol Hepatol 1999;11:727–30. 10.1097/00042737-199907000-00008
    1. Huang YK, Yu JC, Kang WM, et al. . Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis. PLoS One 2015;10:e0142080 10.1371/journal.pone.0142080
    1. Yeh JM, Hur C, Ward Z, et al. . Gastric adenocarcinoma screening and prevention in the era of new biomarker and endoscopic technologies: a cost-effectiveness analysis. Gut 2016;65:563–74. 10.1136/gutjnl-2014-308588
    1. Kuipers EJ. In through the out door: serology for atrophic gastritis. Eur J Gastroenterol Hepatol 2003;15:877–9. 10.1097/01.meg.0000059171.46867.9e
    1. Lomba-Viana R, Dinis-Ribeiro M, Fonseca F, et al. . Serum pepsinogen test for early detection of gastric cancer in a European country. Eur J Gastroenterol Hepatol 2012;24:37–41. 10.1097/MEG.0b013e32834d0a0a
    1. Miki K, Fujishiro M, Kodashima S, et al. . Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc 2009;21:78–81. 10.1111/j.1443-1661.2009.00839.x
    1. Dinis-Ribeiro M, Yamaki G, Miki K, et al. . Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen 2004;11:141–7. 10.1258/0969141041732184
    1. Broutet N, Plebani M, Sakarovitch C, et al. . Pepsinogen A, pepsinogen C, and gastrin as markers of atrophic chronic gastritis in European dyspeptics. Br J Cancer 2003;88:1239–47. 10.1038/sj.bjc.6600877
    1. Terasawa T, Nishida H, Kato K, et al. . Prediction of gastric cancer development by serum pepsinogen test and Helicobacter pylori seropositivity in Eastern Asians: a systematic review and meta-analysis. PLoS One 2014;9:e109783 10.1371/journal.pone.0109783
    1. Yamaguchi Y, Nagata Y, Hiratsuka R, et al. . Gastric cancer screening by combined assay for serum anti-Helicobacter pylori igG antibody and serum pepsinogen levels-the abc method. Digestion 2016;93:13–18. 10.1159/000441742
    1. Lansdorp-Vogelaar I, Kuipers EJ. Screening for gastric cancer in Western countries. Gut 2016;65:543–4. 10.1136/gutjnl-2015-310356
    1. Ikeda F, Shikata K, Hata J, et al. . Combination of Helicobacter pylori antibody and serum pepsinogen as a good predictive tool of gastric cancer incidence: 20-year prospective data from the Hisayama study. J Epidemiol 2016;26:629–36. 10.2188/jea.JE20150258
    1. Zagari RM, Rabitti S, Greenwood DC, et al. . Systematic review with meta-analysis: diagnostic performance of the combination of pepsinogen, gastrin-17 and anti-Helicobacter pylori antibodies serum assays for the diagnosis of atrophic gastritis. Aliment Pharmacol Ther 2017;46:657–67. 10.1111/apt.14248
    1. McNicholl AG, Forné M, Barrio J, et al. . Accuracy of GastroPanel for the diagnosis of atrophic gastritis. Eur J Gastroenterol Hepatol 2014;26:941–8. 10.1097/MEG.0000000000000132
    1. Masci E, Pellicano R, Mangiavillano B, et al. . GastroPanel® test for non-invasive diagnosis of atrophic gastritis in patients with dyspepsia. Minerva Gastroenterol Dietol 2014;60:79–83.
    1. Compare D, Rocco A, Nardone G. Screening for and surveillance of gastric cancer. World J Gastroenterol 2014;20:13681–91. 10.3748/wjg.v20.i38.13681
    1. Amal H, Leja M, Funka K, et al. . Detection of precancerous gastric lesions and gastric cancer through exhaled breath. Gut 2016;65:400–7. 10.1136/gutjnl-2014-308536
    1. Menon S, Trudgill N. How commonly is upper gastrointestinal cancer missed at endoscopy? A meta-analysis. Endosc Int Open 2014;2:E46–50. 10.1055/s-0034-1365524
    1. Beg S, Ragunath K, Wyman A, et al. . Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017;66:1886–99. 10.1136/gutjnl-2017-314109
    1. Bisschops R, Areia M, Coron E, et al. . Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative. Endoscopy 2016;48:843–64. 10.1055/s-0042-113128
    1. Teh JL, Tan JR, Lau LJ, et al. . Longer examination time improves detection of gastric cancer during diagnostic upper gastrointestinal endoscopy. Clin Gastroenterol Hepatol 2015;13:480–7. 10.1016/j.cgh.2014.07.059
    1. Teh JL, Hartman M, Lau L, et al. . Mo1579 duration of endoscopic examination significantly impacts detection rates of neoplastic lesions during diagnostic upper endoscopy. Gastrointest Endosc 2011;73:AB393 10.1016/j.gie.2011.03.878
    1. Taga S. Endoscopy technique. Observation by panendoscopy In: Tada M, Maruyama M, Fujino M, eds I to Cho Handbook. Tokyo: Igakushoin, 1992:132–9.
    1. JSGCS. The committee for standardizing screening gastroscopy. Gastric cancer screeing techniques. Handbook. 1st ed Tokyo: Igakushoin, 2010.
    1. Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 2013;26:11–22.
    1. Zhang Q, Chen Z, Chen C, et al. . Training in early gastric cancer diagnosis improves the detection rate of early gastric cancer. Medicine (Baltimore) 2015;94:e384 10.1097/MD.0000000000000384
    1. Yao K, Uedo N, Muto M, et al. . Development of an e-learning system for teaching endoscopists how to diagnose early gastric cancer: basic principles for improving early detection. Gastric Cancer 2017;20:28–38. 10.1007/s10120-016-0680-7
    1. Yao K, Uedo N, Muto M, et al. . Development of an e-learning system for the endoscopic diagnosis of early gastric cancer: an international multicenter randomized controlled trial. EBioMedicine 2016;9:140–7. 10.1016/j.ebiom.2016.05.016
    1. Nakanishi H, Doyama H, Ishikawa H, et al. . Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study. Endoscopy 2017;49:957–67. 10.1055/s-0043-111888
    1. Yagi K, Aruga Y, Nakamura A, et al. . Regular arrangement of collecting venules (RAC): a characteristic endoscopic feature of Helicobacter pylori-negative normal stomach and its relationship with esophago-gastric adenocarcinoma. J Gastroenterol 2005;40:443–52. 10.1007/s00535-005-1605-0
    1. Yagi K, Honda H, Yang JM, et al. . Magnifying endoscopy in gastritis of the corpus. Endoscopy 2005;37:660–6. 10.1055/s-2005-861423
    1. Yagi K, Nakamura A, Sekine A. Comparison between magnifying endoscopy and histological, culture and urease test findings from the gastric mucosa of the corpus. Endoscopy 2002;34:376–81. 10.1055/s-2002-25281
    1. Cho JH, Chang YW, Jang JY, et al. . Close observation of gastric mucosal pattern by standard endoscopy can predict Helicobacter pylori infection status. J Gastroenterol Hepatol 2013;28:279–84. 10.1111/jgh.12046
    1. Na S, Chung JW, Park HJ, et al. . [The usefulness of the regular arrangement of collecting venules pattern for the determination of Helicobacter pylori Infection]. Korean J Gastroenterol 2011;58:252 10.4166/kjg.2011.58.5.252
    1. Machado RS, Viriato A, Kawakami E, et al. . The regular arrangement of collecting venules pattern evaluated by standard endoscope and the absence of antrum nodularity are highly indicative of Helicobacter pylori uninfected gastric mucosa. Dig Liver Dis 2008;40:68–72. 10.1016/j.dld.2007.08.003
    1. Muto M, Yao K, Kaise M, et al. . Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G). Dig Endosc 2016;28:379–93. 10.1111/den.12638
    1. Bansal A, Ulusarac O, Mathur S, et al. . Correlation between narrow band imaging and nonneoplastic gastric pathology: a pilot feasibility trial. Gastrointest Endosc 2008;67:210–6. 10.1016/j.gie.2007.06.009
    1. Uedo N. Advanced imaging in the diagnosis of gastric intestinal metaplasia: the expert’s approach. Video Journal and Encyclopedia of GI Endoscopy 2013;1:112–4. 10.1016/S2212-0971(13)70049-9
    1. Anagnostopoulos GK, 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. 10.1055/s-2006-945056
    1. Pimentel-Nunes P, Dinis-Ribeiro M, Soares JB, et al. . A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions. Endoscopy 2012;44:236–46. 10.1055/s-0031-1291537
    1. Gonen C, Simsek I, Sarioglu S, et al. . Comparison of high resolution magnifying endoscopy and standard videoendoscopy for the diagnosis of Helicobacter pylori gastritis in routine clinical practice: a prospective study. Helicobacter 2009;14:12–21. 10.1111/j.1523-5378.2009.00650.x
    1. Uedo N, Yao K. Endoluminal diagnosis of early gastric cancer and its precursors: bridging the gap between endoscopy and pathology. Adv Exp Med Biol 2016;908:293–316. 10.1007/978-3-319-41388-4_14
    1. Yao K, Iwashita A, Tanabe H, et al. . White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc 2008;68:574–80. 10.1016/j.gie.2008.04.011
    1. Nakayama Y, Horiuchi A, Kumagai T, et al. . Discrimination of normal gastric mucosa from Helicobacter pylori gastritis using standard endoscopes and a single observation site: studies in children and young adults. Helicobacter 2004;9:95–9. 10.1111/j.1083-4389.2004.00204.x
    1. Redéen S, Petersson F, Jönsson KA, et al. . Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample. Endoscopy 2003;35:946–50. 10.1055/s-2003-43479
    1. Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969;1:87–97. 10.1055/s-0028-1098086
    1. Naylor GM, Gotoda T, Dixon M, et al. . Why does Japan have a high incidence of gastric cancer? Comparison of gastritis between UK and Japanese patients. Gut 2006;55:1545–52. 10.1136/gut.2005.080358
    1. Kono S, Gotoda T, Yoshida S, et al. . Can endoscopic atrophy predict histological atrophy? Historical study in United Kingdom and Japan. World J Gastroenterol 2015;21:13113–23. 10.3748/wjg.v21.i46.13113
    1. Nagata N, Shimbo T, Akiyama J, et al. . Predictability of gastric intestinal metaplasia by mottled patchy erythema seen on endoscopy. Gastroenterology Res 2011;4:203–9. 10.4021/gr357w
    1. Lim JH, Kim N, Lee HS, et al. . Correlation between endoscopic and histological diagnoses of gastric intestinal metaplasia. Gut Liver 2013;7:41–50. 10.5009/gnl.2013.7.1.41
    1. Panteris V, Nikolopoulou S, Lountou A, et al. . Diagnostic capabilities of high-definition white light endoscopy for the diagnosis of gastric intestinal metaplasia and correlation with histologic and clinical data. Eur J Gastroenterol Hepatol 2014;26:1–601. 10.1097/MEG.0000000000000097
    1. Pimentel-Nunes P, Libânio D, Lage J, et al. . A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions. Endoscopy 2016;48:723–30. 10.1055/s-0042-108435
    1. Kikuste I, Stirna D, Liepniece-Karele I, et al. . The accuracy of flexible spectral imaging colour enhancement for the diagnosis of gastric intestinal metaplasia: do we still need histology to select individuals at risk for adenocarcinoma? Eur J Gastroenterol Hepatol 2014;26:704–9. 10.1097/MEG.0000000000000108
    1. Ang TL, Pittayanon R, Lau JY, et al. . A multicenter randomized comparison between high-definition white light endoscopy and narrow band imaging for detection of gastric lesions. Eur J Gastroenterol Hepatol 2015;27:1473–8. 10.1097/MEG.0000000000000478
    1. Buxbaum JL, Hormozdi D, Dinis-Ribeiro M, et al. . Narrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial. Gastrointest Endosc 2017;86:857–65. 10.1016/j.gie.2017.03.1528
    1. Uedo N, Ishihara R, Iishi H, et al. . A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy 2006;38:819–24. 10.1055/s-2006-944632
    1. An JK, Song GA, Kim GH, et al. . Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia. BMC Gastroenterol 2012;12:169 10.1186/1471-230X-12-169
    1. Kanemitsu T, Yao K, Nagahama T, et al. . Extending magnifying NBI diagnosis of intestinal metaplasia in the stomach: the white opaque substance marker. Endoscopy 2017;49:529–35. 10.1055/s-0043-103409
    1. Wang L, Huang W, Du J, et al. . Diagnostic yield of the light blue crest sign in gastric intestinal metaplasia: a meta-analysis. PLoS One 2014;9:e92874 10.1371/journal.pone.0092874
    1. Eshmuratov A, Nah JC, Kim N, et al. . The correlation of endoscopic and histological diagnosis of gastric atrophy. Dig Dis Sci 2010;55:1364–75. 10.1007/s10620-009-0891-4
    1. Zhang Q, Wang F, Chen ZY, et al. . Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis. Gastric Cancer 2016;19:543–52. 10.1007/s10120-015-0500-5
    1. Libânio D, Braga V, Ferraz S, et al. . Prospective comparative study of endoscopic submucosal dissection and gastrectomy for early neoplastic lesions including patients' perspectives. Endoscopy 2019;51:30–9. 10.1055/a-0628-6601
    1. Axon A. Symptoms and diagnosis of gastric cancer at early curable stage. Best Pract Res Clin Gastroenterol 2006;20:697–708. 10.1016/j.bpg.2006.03.015
    1. Coda S, Lee SY, Gotoda T. Endoscopic mucosal resection and endoscopic submucosal dissection as treatments for early gastrointestinal cancers in Western countries. Gut Liver 2007;1:012–21. 10.5009/gnl.2007.1.1.12
    1. Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005;37:570–8. 10.1055/s-2005-861352
    1. Veitch AM, Uedo N, Yao K, et al. . Optimizing early upper gastrointestinal cancer detection at endoscopy. Nat Rev Gastroenterol Hepatol 2015;12:660–7. 10.1038/nrgastro.2015.128
    1. Lauwers GY. Defining the pathologic diagnosis of metaplasia, atrophy, dysplasia, and gastric adenocarcinoma. J Clin Gastroenterol 2003;36:S37–43. 10.1097/00004836-200305001-00007
    1. Park DY, Srivastava A, Kim GH, et al. . Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. Am J Surg Pathol 2008;32:524–33. 10.1097/PAS.0b013e31815b890e
    1. Correa P, Haenszel W, Cuello C, et al. . Gastric precancerous process in a high risk population: cohort follow-up. Cancer Res 1990;50:4737–40.
    1. Uedo N, Iishi H, Tatsuta M, et al. . Longterm outcomes after endoscopic mucosal resection for early gastric cancer. Gastric Cancer 2006;9:88–92. 10.1007/s10120-005-0357-0
    1. Rokkas T, Filipe MI, Sladen GE. Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up. Gut 1991;32:1110–3. 10.1136/gut.32.10.1110
    1. Whiting JL, Sigurdsson A, Rowlands DC, et al. . The long term results of endoscopic surveillance of premalignant gastric lesions. Gut 2002;50:378–81. 10.1136/gut.50.3.378
    1. den Hollander WJ, Holster IL, den Hoed CM, et al. . Surveillance of premalignant gastric lesions: a multicentre prospective cohort study from low incidence regions. Gut 2019;68:585–93. 10.1136/gutjnl-2017-314498
    1. Yeh JM, Hur C, Kuntz KM, et al. . Cost-effectiveness of treatment and endoscopic surveillance of precancerous lesions to prevent gastric cancer. Cancer 2010;116:2941–53. 10.1002/cncr.25030
    1. Areia M, Dinis-Ribeiro M, Rocha Gonçalves F. Cost-utility analysis of endoscopic surveillance of patients with gastric premalignant conditions. Helicobacter 2014;19:425–36. 10.1111/hel.12150
    1. Zhou HJ, Dan YY, Naidoo N, et al. . A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk. PLoS One 2013;8:e83959 10.1371/journal.pone.0083959
    1. Wu JT, Zhou J, Naidoo N, et al. . Determining the cost-effectiveness of endoscopic surveillance for gastric cancer in patients with precancerous lesions. Asia Pac J Clin Oncol 2016;12:359–68. 10.1111/ajco.12569
    1. Di Gregorio C, Morandi P, Fante R, et al. . Gastric dysplasia. A follow-up study. Am J Gastroenterol 1993;88:1714–9.
    1. Fertitta AM, Comin U, Terruzzi V, et al. . Clinical significance of gastric dysplasia: a multicenter follow-up study. Gastrointestinal Endoscopic Pathology Study Group. Endoscopy 1993;25:265–8. 10.1055/s-2007-1010311
    1. Yamada H, Ikegami M, Shimoda T, et al. . Long-term follow-up study of gastric adenoma/dysplasia. Endoscopy 2004;36:390–6. 10.1055/s-2004-814330
    1. Rugge M, Cassaro M, Di Mario F, et al. . The long term outcome of gastric non-invasive neoplasia. Gut 2003;52:1111–6. 10.1136/gut.52.8.1111
    1. Park SY, Jeon SW, Jung MK, et al. . Long-term follow-up study of gastric intraepithelial neoplasias: progression from low-grade dysplasia to invasive carcinoma. Eur J Gastroenterol Hepatol 2008;20:966–70. 10.1097/MEG.0b013e3283013d58
    1. Kokkola A, Haapiainen R, Laxén F, et al. . Risk of gastric carcinoma in patients with mucosal dysplasia associated with atrophic gastritis: a follow up study. J Clin Pathol 1996;49:979–84. 10.1136/jcp.49.12.979
    1. Rugge M, Farinati F, Baffa R, et al. . Gastric epithelial dysplasia in the natural history of gastric cancer: a multicenter prospective follow-up study. Interdisciplinary Group on Gastric Epithelial Dysplasia. Gastroenterology 1994;107:1288–96.
    1. Simone A, Casadei A, De Vergori E, et al. . Rescue endoscopy to identify site of gastric dysplasia or carcinoma found at random biopsies. Dig Liver Dis 2011;43:721–5. 10.1016/j.dld.2011.04.007
    1. Abraham SC, Park SJ, Lee JH, et al. . Genetic alterations in gastric adenomas of intestinal and foveolar phenotypes. Mod Pathol 2003;16:786–95. 10.1097/01.MP.0000080349.37658.5E
    1. Zhao G, Xue M, Hu Y, et al. . How commonly is the diagnosis of gastric low grade dysplasia upgraded following endoscopic resection? A meta-analysis. PLoS One 2015;10:e0132699 10.1371/journal.pone.0132699
    1. Kim YJ, Park JC, Kim JH, et al. . Histologic diagnosis based on forceps biopsy is not adequate for determining endoscopic treatment of gastric adenomatous lesions. Endoscopy 2010;42:620–6. 10.1055/s-0030-1255524
    1. Nam KW, Song KS, Lee HY, et al. . Spectrum of final pathological diagnosis of gastric adenoma after endoscopic resection. World J Gastroenterol 2011;17:5177–83. 10.3748/wjg.v17.i47.5177
    1. Jeon HK, Ryu HY, Cho MY, et al. . A randomized trial to determine the diagnostic accuracy of conventional vs. jumbo forceps biopsy of gastric epithelial neoplasias before endoscopic submucosal dissection; open-label study. Gastric Cancer 2014;17:661–8. 10.1007/s10120-013-0322-2
    1. Goo JJ, Choi CW, Kang DH, et al. . Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: who need en bloc resection? Surg Endosc 2015;29:3761–7. 10.1007/s00464-015-4151-8
    1. Raftopoulos SC, Kumarasinghe P, de Boer B, et al. . Gastric intraepithelial neoplasia in a Western population. Eur J Gastroenterol Hepatol 2012;24:48–54. 10.1097/MEG.0b013e32834dc1bb
    1. Pimentel-Nunes P, Mourão F, Veloso N, et al. . Long-term follow-up after endoscopic resection of gastric superficial neoplastic lesions in Portugal. Endoscopy 2014;46:933–40. 10.1055/s-0034-1377348
    1. Pyo JH, Lee H, Min BH, et al. . Long-term outcome of endoscopic resection vs. surgery for early gastric cancer: a non-inferiority-matched cohort study. Am J Gastroenterol 2016;111:240–9. 10.1038/ajg.2015.427
    1. Kosaka T, Endo M, Toya Y, et al. . Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a single-center retrospective study. Dig Endosc 2014;26:183–91. 10.1111/den.12099
    1. Kato M, Nishida T, Yamamoto K, et al. . Scheduled endoscopic surveillance controls secondary cancer after curative endoscopic resection for early gastric cancer: a multicentre retrospective cohort study by Osaka University ESD study group. Gut 2013;62:1425–32. 10.1136/gutjnl-2011-301647
    1. Horiki N, Omata F, Uemura M, et al. . Risk for local recurrence of early gastric cancer treated with piecemeal endoscopic mucosal resection during a 10-year follow-up period. Surg Endosc 2012;26:72–8. 10.1007/s00464-011-1830-y
    1. Ahn JY, Jung HY, Choi JY, et al. . Natural course of noncurative endoscopic resection of differentiated early gastric cancer. Endoscopy 2012;44:1114–20. 10.1055/s-0032-1325676
    1. Oda I, Gotoda T, Sasako M, et al. . Treatment strategy after non-curative endoscopic resection of early gastric cancer. Br J Surg 2008;95:1495–500. 10.1002/bjs.6305
    1. Yoon H, Kim SG, Choi J, et al. . Risk factors of residual or recurrent tumor in patients with a tumor-positive resection margin after endoscopic resection of early gastric cancer. Surg Endosc 2013;27:1561–8. 10.1007/s00464-012-2627-3
    1. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, et al. . Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015;47:829–54. 10.1055/s-0034-1392882
    1. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14:113–23. 10.1007/s10120-011-0042-4
    1. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017;20:1–19. 10.1007/s10120-016-0622-4
    1. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31–49.
    1. Qiu MZ, Cai MY, Zhang DS, et al. . Clinicopathological characteristics and prognostic analysis of Lauren classification in gastric adenocarcinoma in China. J Transl Med 2013;11:58 10.1186/1479-5876-11-58
    1. Gotoda T, Yanagisawa A, Sasako M, et al. . Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 2000;3:219–25. 10.1007/PL00011720
    1. Hirasawa T, Gotoda T, Miyata S, et al. . Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer 2009;12:148–52. 10.1007/s10120-009-0515-x
    1. Hasuike N, Ono H, Boku N, et al. . A non-randomized confirmatory trial of an expanded indication for endoscopic submucosal dissection for intestinal-type gastric cancer (cT1a): the Japan Clinical Oncology Group study (JCOG0607). Gastric Cancer 2018;21:114–23. 10.1007/s10120-017-0704-y
    1. Probst A, Schneider A, Schaller T, et al. . Endoscopic submucosal dissection for early gastric cancer: are expanded resection criteria safe for Western patients? Endoscopy 2017;49:855–65. 10.1055/s-0043-110672
    1. Hatta W, Gotoda T, Oyama T, et al. . A scoring system to stratify curability after endoscopic submucosal dissection for early gastric cancer: “eCura system”. Am J Gastroenterol 2017;112:874–81. 10.1038/ajg.2017.95
    1. Facciorusso A, Antonino M, Di Maso M, et al. . Endoscopic submucosal dissection vs endoscopic mucosal resection for early gastric cancer: a meta-analysis. World J Gastrointest Endosc 2014;6:555–63. 10.4253/wjge.v6.i11.555
    1. Takekoshi T, Baba Y, Ota H, et al. . Endoscopic resection of early gastric carcinoma: results of a retrospective analysis of 308 cases. Endoscopy 1994;26:352–8. 10.1055/s-2007-1008990
    1. Hiki Y, Shimao H, Mieno H, et al. . Modified treatment of early gastric cancer: evaluation of endoscopic treatment of early gastric cancers with respect to treatment indication groups. World J Surg 1995;19:517–22. 10.1007/BF00294712
    1. Nagano H, Ohyama S, Fukunaga T, et al. . Indications for gastrectomy after incomplete EMR for early gastric cancer. Gastric Cancer 2005;8:149–54. 10.1007/s10120-005-0328-5
    1. Tanabe S, Ishido K, Higuchi K, et al. . Long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a retrospective comparison with conventional endoscopic resection in a single center. Gastric Cancer 2014;17:130–6. 10.1007/s10120-013-0241-2
    1. Oda I, Gotoda T, Hamanaka H, et al. . Endoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and complications from a large consecutive series. Digestive Endoscopy 2005;17:54–8. 10.1111/j.1443-1661.2005.00459.x
    1. Lian J, Chen S, Zhang Y, et al. . A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc 2012;76:763–70. 10.1016/j.gie.2012.06.014
    1. Park YM, Cho E, Kang HY, et al. . The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc 2011;25:2666–77. 10.1007/s00464-011-1627-z
    1. Ono H, Yao K, Fujishiro M, et al. . Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. Dig Endosc 2016;28:3–15. 10.1111/den.12518
    1. Farhat S, Chaussade S, Ponchon T, et al. . Endoscopic submucosal dissection in a European setting. A multi-institutional report of a technique in development. Endoscopy 2011;43:664–70. 10.1055/s-0030-1256413
    1. Wu CY, Wu MS, Kuo KN, et al. . Effective reduction of gastric cancer risk with regular use of nonsteroidal anti-inflammatory drugs in Helicobacter pylori-infected patients. J Clin Oncol 2010;28:2952–7. 10.1200/JCO.2009.26.0695
    1. Tian W, Zhao Y, Liu S, et al. . Meta-analysis on the relationship between nonsteroidal anti-inflammatory drug use and gastric cancer. Eur J Cancer Prev 2010;19:288–98. 10.1097/CEJ.0b013e328339648c
    1. Wang WH, Huang JQ, Zheng GF, et al. . Non-steroidal anti-inflammatory drug use and the risk of gastric cancer: a systematic review and meta-analysis. J Natl Cancer Inst 2003;95:1784–91. 10.1093/jnci/djg106
    1. Leung WK, Ng EK, Chan FK, et al. . Effects of long-term rofecoxib on gastric intestinal metaplasia: results of a randomized controlled trial. Clin Cancer Res 2006;12:4766–72. 10.1158/1078-0432.CCR-06-0693
    1. Yanaoka K, Oka M, Yoshimura N, et al. . Preventive effects of etodolac, a selective cyclooxygenase-2 inhibitor, on cancer development in extensive metaplastic gastritis, a Helicobacter pylori-negative precancerous lesion. Int J Cancer 2010;126:1467–73. 10.1002/ijc.24862
    1. Hung KH, Yang HB, Cheng HC, et al. . Short-term celecoxib to regress long-term persistent gastric intestinal metaplasia after Helicobacter pylori eradication. J Gastroenterol Hepatol 2010;25:48–53. 10.1111/j.1440-1746.2009.05974.x
    1. Yang HB, Cheng HC, Sheu BS, et al. . Chronic celecoxib users more often show regression of gastric intestinal metaplasia after Helicobacter pylori eradication. Aliment Pharmacol Ther 2007;25:455–61. 10.1111/j.1365-2036.2006.03224.x
    1. Zhang LJ, Wang SY, Huo XH, et al. . Anti-Helicobacter pylori therapy followed by celecoxib on progression of gastric precancerous lesions. World J Gastroenterol 2009;15:2731–8. 10.3748/wjg.15.2731
    1. Akre K, Ekström AM, Signorello LB, et al. . Aspirin and risk for gastric cancer: a population-based case-control study in Sweden. Br J Cancer 2001;84:965–8. 10.1054/bjoc.2001.1702
    1. Huang XZ, Chen Y, Wu J, et al. . Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: a dose-response meta-analysis. Oncotarget 2017;8:4781–95. 10.18632/oncotarget.13591
    1. Correa P, Fontham ET, Bravo JC, et al. . Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. J Natl Cancer Inst 2000;92:1881–8. 10.1093/jnci/92.23.1881
    1. You WC, Brown LM, Zhang L, et al. . Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst 2006;98:974–83. 10.1093/jnci/djj264
    1. Plummer M, Vivas J, Lopez G, et al. . Chemoprevention of precancerous gastric lesions with antioxidant vitamin supplementation: a randomized trial in a high-risk population. J Natl Cancer Inst 2007;99:137–46. 10.1093/jnci/djk017
    1. Ferlay J. Cancer incidence and mortality worldwide. Ervik M, Lyon: France: International Agency for Research on Cancer, 2013.
    1. Hamashima C, Ogoshi K, Narisawa R, et al. . Impact of endoscopic screening on mortality reduction from gastric cancer. World J Gastroenterol 2015;21:2460–6. 10.3748/wjg.v21.i8.2460
    1. Hamashima C, Shabana M, Okada K, et al. . Mortality reduction from gastric cancer by endoscopic and radiographic screening. Cancer Sci 2015;106:1744–9. 10.1111/cas.12829
    1. Hosokawa O, Shinbo T, Matsuda K, et al. . Impact of opportunistic endoscopic screening on the decrease of mortality from gastric cancer. J Gastroint Cancer Screen 2011;106:401–7.
    1. Riecken B, Pfeiffer R, Ma JL, et al. . No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk. Prev Med 2002;34:22–8. 10.1006/pmed.2001.0925
    1. Matsumoto S, Yamasaki K, Tsuji K, et al. . Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital, Nagasaki Prefecture. World J Gastroenterol 2007;13:4316–20. 10.3748/wjg.v13.i32.4316
    1. Matsumoto S, Yoshida Y. Efficacy of endoscopic screening in an isolated island: a case-control study. Indian J Gastroenterol 2014;33:46–9. 10.1007/s12664-013-0378-2
    1. Hamashima C, Ogoshi K, Okamoto M, et al. . A community-based, case-control study evaluating mortality reduction from gastric cancer by endoscopic screening in Japan. PLoS One 2013;8:e79088 10.1371/journal.pone.0079088
    1. Hosokawa O, Hattori M, Takeda T, et al. . Accuracy of endoscopy in detecting gastric cancer. J Gastroenterol Mass Surv 2004;14:33–9.
    1. Choi KS, Jun JK, Park EC, et al. . Performance of different gastric cancer screening methods in Korea: a population-based study. PLoS One 2012;7:e50041 10.1371/journal.pone.0050041
    1. Hamashima C, Okamoto M, Shabana M, et al. . Sensitivity of endoscopic screening for gastric cancer by the incidence method. Int J Cancer 2013;133:653–9. 10.1002/ijc.28065
    1. Otsuji M, Kouno Y, Otsuji A, et al. . Assessment of small diameter panendoscopy for diagnosis of gastric cancer: comparative study with follow-up survey date. Stomach Intest 1989;24:1291–7.
    1. Gupta N, Bansal A, Wani SB, et al. . Endoscopy for upper GI cancer screening in the general population: a cost-utility analysis. Gastrointest Endosc 2011;74:610–24. 10.1016/j.gie.2011.05.001
    1. Lee YC, Lin JT, Wu HM, et al. . Cost-effectiveness analysis between primary and secondary preventive strategies for gastric cancer. Cancer Epidemiol Biomarkers Prev 2007;16:875–85. 10.1158/1055-9965.EPI-06-0758
    1. Areia M, Spaander MC, Kuipers EJ, et al. . Endoscopic screening for gastric cancer: a cost-utility analysis for countries with an intermediate gastric cancer risk. United European Gastroenterol J 2018;6:205064061772290 10.1177/2050640617722902
    1. Shawihdi M, Thompson E, Kapoor N, et al. . Variation in gastroscopy rate in English general practice and outcome for oesophagogastric cancer: retrospective analysis of Hospital Episode Statistics. Gut 2014;63:250–61. 10.1136/gutjnl-2012-304202
    1. Leung WK, Ho HJ, Lin JT, et al. . Prior gastroscopy and mortality in patients with gastric cancer: a matched retrospective cohort study. Gastrointest Endosc 2018;87:119–27. 10.1016/j.gie.2017.06.013
    1. Carmack SW, Genta RM, Graham DY, et al. . Management of gastric polyps: a pathology-based guide for gastroenterologists. Nat Rev Gastroenterol Hepatol 2009;6:331–41. 10.1038/nrgastro.2009.70
    1. Evans JA, Chandrasekhara V, Chathadi KV, et al. . The role of endoscopy in the management of premalignant and malignant conditions of the stomach. Gastrointest Endosc 2015;82:1–8. 10.1016/j.gie.2015.03.1967
    1. Graham JR. Gastric polyposis: onset during long-term therapy with omeprazole. Med J Aust 1992;157:287–8.
    1. Chandrasekhara V, Ginsberg GG. Endoscopic management of gastrointestinal stromal tumors. Curr Gastroenterol Rep 2011;13:532–9. 10.1007/s11894-011-0224-6
    1. Islam RS, Patel NC, Lam-Himlin D, et al. . Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions. Gastroenterol Hepatol 2013;9:640–51.
    1. Han JS, Jang JS, Choi SR, et al. . A study of metachronous cancer after endoscopic resection of early gastric cancer. Scand J Gastroenterol 2011;46:1099–104. 10.3109/00365521.2011.591427
    1. Ahn JY, Son DH, Choi KD, et al. . Neoplasms arising in large gastric hyperplastic polyps: endoscopic and pathologic features. Gastrointest Endosc 2014;80:1005–13. 10.1016/j.gie.2014.04.020
    1. Kang HM, Oh TH, Seo JY, et al. . [Clinical factors predicting for neoplastic transformation of gastric hyperplastic polyps]. Korean J Gastroenterol 2011;58:184–9. 10.4166/kjg.2011.58.4.184
    1. Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol 1987;82:1016–25.
    1. Dirschmid K, Platz-Baudin C, Stolte M. Why is the hyperplastic polyp a marker for the precancerous condition of the gastric mucosa? Virchows Arch 2006;448:80–4. 10.1007/s00428-005-0068-2
    1. Ginsberg GG, Al-Kawas FH, Fleischer DE, et al. . Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol 1996;91:714–7.
    1. Rattan J, Arber N, Tiomny E, et al. . Gastric polypoid lesions-an eight-year study. Hepatogastroenterology 1993;40:107–9.
    1. Hizawa K, Fuchigami T, Iida M, et al. . Possible neoplastic transformation within gastric hyperplastic polyp. Application of endoscopic polypectomy. Surg Endosc 1995;9:714–8.
    1. Zea-Iriarte WL, Sekine I, Itsuno M, et al. . Carcinoma in gastric hyperplastic polyps. A phenotypic study. Dig Dis Sci 1996;41:377–86.
    1. Cristallini EG, Ascani S, Bolis GB. Association between histologic type of polyp and carcinoma in the stomach. Gastrointest Endosc 1992;38:481–4. 10.1016/S0016-5107(92)70481-7
    1. Harju E. Gastric polyposis and malignancy. Br J Surg 1986;73:532–3. 10.1002/bjs.1800730705
    1. Markowski AR, Markowska A, Guzinska-Ustymowicz K. Pathophysiological and clinical aspects of gastric hyperplastic polyps. World J Gastroenterol 2016;22:8883–91. 10.3748/wjg.v22.i40.8883
    1. Uedo N, Yamaoka R, Yao K. Multiple white flat lesions in the gastric corpus are not intestinal metaplasia. Endoscopy 2017;49:615–6. 10.1055/s-0043-106434
    1. Hasegawa R, Yao K, Ihara S, et al. . Magnified endoscopic findings of multiple white flat lesions: a new subtype of gastric hyperplastic polyps in the stomach. Clin Endosc 2018;51:558–62. 10.5946/ce.2018.104
    1. Han AR, Sung CO, Kim KM, et al. . The clinicopathological features of gastric hyperplastic polyps with neoplastic transformations: a suggestion of indication for endoscopic polypectomy. Gut Liver 2009;3:271–5. 10.5009/gnl.2009.3.4.271
    1. Stolte M, Sticht T, Eidt S, et al. . Frequency, location, and age and sex distribution of various types of gastric polyp. Endoscopy 1994;26:659–65. 10.1055/s-2007-1009061
    1. Laxén F, Sipponen P, Ihamäki T, et al. . Gastric polyps; their morphological and endoscopical characteristics and relation to gastric carcinoma. Acta Pathol Microbiol Immunol Scand A 1982;90:221–8. 10.1111/j.1699-0463.1982.tb00085_90A.x
    1. Omori T, Kamiya Y, Tahara T, et al. . Correlation between magnifying narrow band imaging and histopathology in gastric protruding/or polypoid lesions: a pilot feasibility trial. BMC Gastroenterol 2012;12:17 10.1186/1471-230X-12-17
    1. Kanesaka T, Sekikawa A, Tsumura T, et al. . Dense-type crypt opening seen on magnifying endoscopy with narrow-band imaging is a feature of gastric adenoma. Dig Endosc 2014;26:57–62. 10.1111/den.12076
    1. Yao K, Iwashita A, Nambu M, et al. . Nature of white opaque substance in gastric epithelial neoplasia as visualized by magnifying endoscopy with narrow-band imaging. Dig Endosc 2012;24:419–25. 10.1111/j.1443-1661.2012.01314.x
    1. Colling C, Asztalos I, Buchner AM, et al. . Mo2037 narrow-band imaging classification system for gastric polyps may reduce the need for biopsies. Gastrointest Endosc 2017;85:AB531 10.1016/j.gie.2017.03.1224
    1. Muehldorfer SM, Stolte M, Martus P, et al. . Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut 2002;50:465–70. 10.1136/gut.50.4.465
    1. Brown H, Wyatt S, Croft S, et al. . An evaluation of endoscopycapacity across the NHS in England. London: Cancer Research UK, 2015.
    1. Ross-Innes CS, Debiram-Beecham I, O’Donovan M, et al. . Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett’s esophagus: a multi-center case-control study. PLoS Med 2015;12:e1001780 10.1371/journal.pmed.1001780
    1. Dinis-Ribeiro M, da Costa-Pereira A, Lopes C, et al. . Magnification chromoendoscopy for the diagnosis of gastric intestinal metaplasia and dysplasia. Gastrointest Endosc 2003;57:498–504. 10.1067/mge.2003.145
    1. Guo YT, Li YQ, Yu T, et al. . Diagnosis of gastric intestinal metaplasia with confocal laser endomicroscopy in vivo: a prospective study. Endoscopy 2008;40:547–53. 10.1055/s-2007-995633
    1. Tahara T, Shibata T, Nakamura M, et al. . Gastric mucosal pattern by using magnifying narrow-band imaging endoscopy clearly distinguishes histological and serological severity of chronic gastritis. Gastrointest Endosc 2009;70:246–53. 10.1016/j.gie.2008.11.046
    1. Capelle LG, Haringsma J, de Vries AC, et al. . Narrow band imaging for the detection of gastric intestinal metaplasia and dysplasia during surveillance endoscopy. Dig Dis Sci 2010;55:3442–8. 10.1007/s10620-010-1189-2
    1. Kawamura M, Abe S, Oikawa K, et al. . Topographic differences in gastric micromucosal patterns observed by magnifying endoscopy with narrow band imaging. J Gastroenterol Hepatol 2011;26:477–83. 10.1111/j.1440-1746.2010.06527.x
    1. Rerknimitr R, Imraporn B, Klaikeaw N, et al. . Non-sequential narrow band imaging for targeted biopsy and monitoring of gastric intestinal metaplasia. World J Gastroenterol 2011;17:1336–42. 10.3748/wjg.v17.i10.1336
    1. Dutta AK, Sajith KG, Pulimood AB, et al. . Narrow band imaging versus white light gastroscopy in detecting potentially premalignant gastric lesions: a randomized prospective crossover study. Indian J Gastroenterol 2013;32:37–42. 10.1007/s12664-012-0246-5
    1. Kanzaki H, Uedo N, Ishihara R, et al. . Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis. Helicobacter 2012;17:224–31. 10.1111/j.1523-5378.2012.00938.x
    1. Savarino E, Corbo M, Dulbecco P, et al. . Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia. World J Gastroenterol 2013;19:2668–75. 10.3748/wjg.v19.i17.2668
    1. Fukuta N, Ida K, Kato T, et al. . Endoscopic diagnosis of gastric intestinal metaplasia: a prospective multicenter study. Dig Endosc 2013;25:526–34. 10.1111/den.12032
    1. Pittayanon R, Rerknimitr R, Wisedopas N, et al. . Flexible spectral imaging color enhancement plus probe-based confocal laser endomicroscopy for gastric intestinal metaplasia detection. J Gastroenterol Hepatol 2013;28:1004–9. 10.1111/jgh.12185
    1. Xirouchakis E, Laoudi F, Tsartsali L, et al. . Screening for gastric premalignant lesions with narrow band imaging, white light and updated Sydney protocol or both? Dig Dis Sci 2013;58:1084–90. 10.1007/s10620-012-2431-x
    1. Nomura S, Ida K, Terao S, et al. . Endoscopic diagnosis of gastric mucosal atrophy: multicenter prospective study. Dig Endosc 2014;26:709–19. 10.1111/den.12286
    1. Sha J, Wang P, Zhu B, et al. . Acetic acid enhanced narrow band imaging for the diagnosis of gastric intestinal metaplasia. PLoS One 2017;12:e0170957 10.1371/journal.pone.0170957

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj