Scandinavian Journal of Gastroenterology最新文献

{"title":"Gastrointestinal surveillance in patients with multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome.","authors":"Samuel A Schueler, Sonia L T Sharma, Natasha Kamal, Jenny E Blau, Stephen A Wank, Sheila Kumar","doi":"10.1080/00365521.2025.2541209","DOIUrl":"10.1080/00365521.2025.2541209","url":null,"abstract":"<p><strong>Backgrounds and aims: </strong>No guidelines exist for gastric acid assessment (GAA) or endoscopic surveillance for patients with Multiple Endocrine Neoplasia Type 1-Zollinger-Ellison Syndrome (MEN1-ZES). We aimed to analyze how GAA via nasogastric tube (NGT) and esophagogastro-duodenoscopy (EGD) altered acid suppression therapy and identify pre-GAA factors associated with post-GAA medication changes to inform which patients benefit from GAAs and/or EGDs for surveillance.</p><p><strong>Methods: </strong>We assessed the following data from patients at our institution with MEN1-ZES from 2004-2018: 1) pre-GAA gastrointestinal symptoms; 2) serum gastrin levels; 3) gastric acid output (GAO); 4) EGD findings; 5) post-GAA changes in acid suppressing medication. GAO of <10 milliequivalents (mEq) of hydrochloric acid per hour (hr) indicated adequate acid suppression.</p><p><strong>Results: </strong>Fifty-one patients who underwent 313 EGD/GAAs were identified; 263 EGD/GAAs were included. 51/263 EGD/GAAs (19.4%) led to increased acid suppression medication. Of these, 47.1% had GAO > 10 mEq/hr. Patients who had increases in acid suppression medication had significantly more symptoms, abnormal endoscopic findings, and higher GAOs compared to patients treated with same or decreased dose after endoscopy. All patients without symptoms prior to EGD/GAA were adequately suppressed. 8 NGT/GAAs done in 6 asymptomatic patients demonstrated adequate suppression.</p><p><strong>Conclusion: </strong>GAA is inadequately sensitive for detecting which patients with MEN1-ZES will benefit from increased acid suppression medication. Patients with symptoms should undergo EGD. A majority of patients without symptoms will not require increased acid suppressing medication following GAA, but a few asymptomatic patients may have endoscopic findings warranting increased therapy. There is no clear clinical benefit for NGT/GAA in asymptomatic patients.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"966-971"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in non-coeliac gluten/wheat sensitivity: a self-managed problem?","authors":"F Manza, S A Raju, R M Harrop, K A L Kennedy, L Lungaro, C Cotton, I Aziz, G Caio, D S Sanders","doi":"10.1080/00365521.2025.2554346","DOIUrl":"10.1080/00365521.2025.2554346","url":null,"abstract":"<p><strong>Introduction: </strong>Self-reported non-coeliac gluten/wheat sensitivity (NCGWS) is triggered by gluten/wheat ingestion in patients without coeliac disease (CD) or wheat allergy. Following the COVID-19 pandemic, diagnoses of NCGWS appear to have declined. A gluten/wheat-free diet (GFD) remains the only management approach, though long-term adherence and outcomes are unclear. This study aimed to evaluate market trends and the long-term GFD adherence in NCGWS. Secondary objectives included evaluating perceived GFD efficacy and the need for further healthcare advice.</p><p><strong>Methods: </strong>We analyzed UK market data on gluten-free (GF) product sales through September 2024 and shopper insights through July 2021. Additionally, patients with self-reported NCGWS diagnosed between 2006 and 2018 at a tertiary center completed a follow-up questionnaire about their dietary habits and further need of medical advice. GFD adherence was assessed using the Biagi score and compared with a matched cohort of CD patients.</p><p><strong>Results: </strong>Market analysis showed a continued rise in GF product sales, from £214 m in 2014 to £607 m in 2024. NCGWS patients represented 9.7% of buyers. Of 186 patients, 111 completed the questionnaire. Compared to CD patients, those with NCGWS had significantly lower GFD adherence (Biagi score 0-1: NCGWS 73.9% <i>vs</i>. CD 8.1%; score 3-4: NCGWS 24.3% <i>vs.</i> CD 90.1%; <i>p</i> < 0.05). After discharge, 36% (<i>n</i> = 40) sought further medical advice, with no significant link between GFD adherence and need for intervention.</p><p><strong>Conclusions: </strong>Although previous data suggests a drop in referrals to secondary care, up to 9.7% of our people are eating GF to treat self-reported NCGWS. The long-term GFD adherence is poor.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"949-957"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment patterns and clinical outcomes of patients with hepatocellular carcinoma-a cohort study of 1020 patients in Sweden.","authors":"Bonnie Bengtsson, Linnea Widman, Per Stål, Hannes Hagström","doi":"10.1080/00365521.2025.2531042","DOIUrl":"10.1080/00365521.2025.2531042","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatocellular carcinoma (HCC) is a significant global health burden. Examining treatment sequencing before the introduction of immune-based therapies is important for understanding the role and necessity of modern treatment approaches.</p><p><strong>Material and methods: </strong>This retrospective study analysed 1020 patients with HCC treated at Karolinska University Hospital, Stockholm, between 2010 and 2017 to explore treatment sequencing, and clinical outcomes. Treatment decisions followed a modified Barcelona Clinic Liver Cancer (BCLC) algorithm, and patients were stratified by disease stage and by type of treatment.</p><p><strong>Results: </strong>Initial treatment strategies included best supportive care (BSC, 32%), ablation (20%), transarterial chemoembolization (TACE, 22%), systemic therapy (12%), resection (12%), and liver transplantation (3%). Median survival ranged from 4.8 years in BCLC 0 to 2.3 months in BCLC D. Curative treatments, particularly liver transplantation, achieved the highest five-year survival (82%), whereas systemic therapy and BSC had the poorest five-year survival (2% and 0%). Despite curative intent, disease recurrence was common, necessitating further treatment in most patients. Treatment sequencing revealed that 37% of patients required a second treatment, and 18% progressed to a third line of therapy.</p><p><strong>Conclusions: </strong>This study underscores the challenges of managing HCC in a real-world setting, including late diagnosis and high recurrence rates following curative treatments. Real-world treatment deviations from guidelines were observed, often influenced by patient comorbidities, performance status, or other clinical considerations.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1023-1031"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intake of fiber and micronutrients in patients with IBS.","authors":"Bodil Roth, Dalia Al-Shareef, Bodil Ohlsson","doi":"10.1080/00365521.2025.2535721","DOIUrl":"10.1080/00365521.2025.2535721","url":null,"abstract":"<p><strong>Background and aim: </strong>Irritable bowel syndrome (IBS) is characterized by abdominal pain and altered bowel habits. Overweight and poor nutrient intake has been described in these patients. The aim of the study was to estimate nutrient intake in IBS, and to relate symptoms with nutrient intake and weight.</p><p><strong>Methods: </strong>Patients with IBS diagnosed according to Rome IV, without other severe diseases, completed a study questionnaire, IBS-severity scoring system (IBS-SSS), visual analog scale for IBS (VAS-IBS), and food diaries for 3 days. Mean intake of each nutrient per day was calculated. Recommended or adequate intake was a cut off for normal or low/high intake.</p><p><strong>Results: </strong>In total, 155 patients, 130 (83.9%) women, 42 (32-55) years old, weight 69.2 (63.0-82.9) kg, were included. Fiber intake was low in 91.0% of participants, whereas sodium intake was high in 71.6%. Intakes of vitamin A, vitamin D, riboflavin, vitamin B6, folate, vitamin B12, calcium, vitamin C, calcium, iron, magnesium, potassium, selenium, and zinc were reduced in ≥60% of participants. Half of the participants had a low intake of ≥11 of the 19 micronutrients measured. Most prominently, 85.8% had a low intake of vitamin D and 91.6% of selenium. 50.3% were overweight, and weight correlated with energy intake. Extraintestinal symptoms were associated with weight/BMI but not nutrients.</p><p><strong>Conclusions: </strong>Patients with IBS are often overweight with a low intake of fiber and several micronutrients but a high intake of sodium. Effects of micronutrient deficiency on gut microbiota, intestinal integrity, and immune system need to be further studied.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1011-1022"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study showcasing the difficulties in endoscopic biliary drainage using uncovered self-expanding metal stents for resectable perihilar cholangiocarcinoma.","authors":"David M de Jong, Bas Groot Koerkamp, Wojciech G Polak, Jeroen de Jonge, Jan N M IJzermans, Michael Doukas, Roy S Dwarkasing, Marco J Bruno, Lydi M J W van Driel","doi":"10.1080/00365521.2025.2542873","DOIUrl":"10.1080/00365521.2025.2542873","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangio-pancreatography (ERCP) with plastic stent placement is the standard pertaining preoperative biliary drainage for resectable perihilar cholangiocarcinoma (pCCA). Uncovered self-expanding metal stents (ucSEMS) have shown better outcomes in palliative settings. This pilot study aimed to assess the feasibility and safety of direct ucSEMS placement <i>via</i> ERCP for resectable pCCA.</p><p><strong>Materials and methods: </strong>In this single-centre pilot study, ten patients with presumed resectable pCCA (without prior drainage) underwent ERCP aiming to place an ucSEMS directly across the papilla into the future liver remnant (FLR). If the opposing liver segment was cannulated or had contrast injected, a stent was placed here too. Primary outcome was feasibility, defined as ucSEMS placement in the targeted liver segment without the need for additional drainage, with adequate bilirubin decrease according to the TOKYO criteria. Secondary outcomes included ERCP adverse events (AE) and successful stent removal during surgery.</p><p><strong>Results: </strong>In 5 of the 10 included patients, direct ucSEMS placement in the FLR was technically successful, but one required additional intervention, resulting in 40% feasibility. All patients experienced ERCP-AE (five mild, five severe). Only two patients underwent hepatectomy, one after unsuccessful ERCP and one with successful ucSEMS removal during hepatectomy. Other patients did not proceed to hepatectomy due to ERCP-related AE (<i>n</i> = 3), disease progression (<i>n</i> = 2), or unresectability upon staging (<i>n</i> = 3).</p><p><strong>Conclusion: </strong>Direct placement of ucSEMS for resectable pCCA showed limited feasibility and high AE rates. Its routine use is not justified without further refinement and larger studies to reduce AE and improve outcomes.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"938-948"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of tumour recurrence following curative treatment of hepatocellular carcinoma.","authors":"Bonnie Bengtsson, Gustaf Pak, Juan Vaz, Linnea Widman, Hannes Hagström","doi":"10.1080/00365521.2025.2565334","DOIUrl":"https://doi.org/10.1080/00365521.2025.2565334","url":null,"abstract":"<p><strong>Objectives: </strong>Tumour recurrence remains a major obstacle to long-term survival following curative treatment for hepatocellular carcinoma (HCC). This cohort study aimed to identify clinical and tumour-related factors associated with HCC recurrence.</p><p><strong>Methods: </strong>A total of 346 patients treated with curative intent at Karolinska University Hospital between 2010 and 2017 were analysed. Patients were stratified by treatment modality and recurrence status.</p><p><strong>Results: </strong>Resection (adjusted hazard ratio [aHR] = 6.0, 95%CI = 2.5-14.5) and ablation (aHR = 10.3, 95%CI = 4.5-23.7) were independently associated with higher recurrence compared to liver transplantation. Alpha-fetoprotein (AFP) levels ≥100 µg/L (aHR = 3.1, 95%CI = 2.0-4.7) and active smoking at baseline (aHR = 1.7, 95%CI = 1.1-2.6) were significantly associated with recurrence.</p><p><strong>Conclusion: </strong>These findings highlight the relevance of AFP in recurrence prediction and surveillance planning and points out that smoking history can be of importance although this needs to be further validated.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic papillectomy in Germany: a comprehensive analysis of clinical trends and hospital mortality in Germany.","authors":"Jennis Kandler, Tobias Essing, Alexander Mertens, Anselm Kunstein, Christoph Roderburg, Tom Luedde, Sven H Loosen","doi":"10.1080/00365521.2025.2557416","DOIUrl":"https://doi.org/10.1080/00365521.2025.2557416","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic papillectomy (EP) is a minimally invasive alternative to surgical resection for early ampullary neoplasia. While its use is increasing, outcomes and complication rates vary, and reliable data on hospital mortality in Germany remain scarce.</p><p><strong>Methods: </strong>We analyzed clinical trends and hospital mortality of EP in Germany from 2018 to 2022 using standardized hospital discharge data from the Federal Statistical Office.</p><p><strong>Results: </strong>Between 2018 and 2022, 3366 EPs were performed in Germany. Annual procedures rose from 557 in 2018 to 750 in 2022. Median hospital stay was 8.71 days. Overall hospital mortality was 1.75%, higher among women (2.0%) and patients >70 years (2.2%). Bleeding (16.8%) and post-EP pancreatitis (PEPP, 13.2%) were the most common complications. Key factors associated with increased mortality included mechanical ventilation (42.5%), acute renal failure (21.5%), and biliary or duodenal perforations (17.6%/13.5%). Stenting of the main pancreatic duct (MPD) did not affect PEPP rates (13.31% vs. 13.12%) but showed a non-significant trend toward lower mortality (1.40% vs. 1.95%, <i>p</i> = 0.236).</p><p><strong>Conclusion: </strong>EP is increasingly used in Germany and remains a minimally invasive, organ-preserving procedure with a low hospital mortality of 1.75%, slightly higher than previously reported but still favorable compared to surgery. Identified complications may support better patient selection and improve peri- and post-interventional management to reduce risks and enhance outcomes.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a machine learning model for predicting gastrointestinal bleeding in patients with direct oral anticoagulants.","authors":"Ilsoo Kim, Jong-Uk Hou, Jae Hong Choe, Joon Sung Kim, Dae Young Cheung, Byung-Wook Kim","doi":"10.1080/00365521.2025.2565321","DOIUrl":"10.1080/00365521.2025.2565321","url":null,"abstract":"<p><strong>Background and aim: </strong>Direct oral anticoagulants (DOACs) carry a risk of gastrointestinal bleeding (GIB). We aimed to develop and validate machine learning (ML) models to predict GIB in DOAC users and compare them with conventional risk scores.</p><p><strong>Methods: </strong>We retrospectively analyzed 4,494 patients aged ≥18 years prescribed DOACs from December 2014 to October 2020. Patients were allocated to the training (<i>n</i> = 3,147), internal (<i>n</i> = 677), and external (<i>n</i> = 670) validation cohorts. Three ML algorithms, Gradient Boosting Machine (GBM), XGBoost, and Generalized Linear Model (GLM), predicted GIB at 12 and 24 months. Performance was assessed using the area under the receiver operating characteristic curve (AUC) and specificity at 100% sensitivity, compared with the HAS-BLED, ATRIA, VTE-BLEED, and ORBIT scores.</p><p><strong>Results: </strong>At 24 months, XGBoost achieved the AUCs in the training (0.862), internal validation (0.819), and external validation (0.905) sets. At 12 months, XGBoost performed with AUCs of 0.917, 0.839, and 0.948, respectively. XGBoost exceeded the conventional scores, although ORBIT was the best among the latter (AUC 0.780 at 24 months, 0.728 at 12 months). The ML models also achieved higher specificity at 100% sensitivity. At 12 months, XGBoost and GB model demonstrated 79.8% specificity at 100% sensitivity, whereas GLM showed 67.8%. The conventional models were lower, with an ORBIT of 39.8%. By 24 months, GLM and ORBIT specificities were 43.8% and 40.0%, respectively.</p><p><strong>Conclusions: </strong>ML models, particularly XGBoost, outperformed traditional bleeding risk scores in predicting GIB in DOAC users. However, the performance of the ML models was unsatisfactory. Further research is warranted to achieve a better performance.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling NOSTRIN as a potential diagnostic marker of vascular impairment in MASLD.","authors":"Balasubramaniyan Vairappan, Kalaivani Subramani, Deepthi Sudha Machavaram, Sunitha Vs, Jayaprakash Sahoo","doi":"10.1080/00365521.2025.2563587","DOIUrl":"https://doi.org/10.1080/00365521.2025.2563587","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) complications are an expanding health problem concomitant with endothelial dysfunction (ED) at early stages of the disease. This study aimed to identify the levels of a novel endothelial nitric oxide synthase (eNOS) trafficking inducer, Nostrin, in patients with MASLD compared to healthy volunteers (HV). Additionally, we investigated the association between Nostrin and endothelial dysfunction (ED) in MASLD patients.</p><p><strong>Materials and methods: </strong>This cross-sectional analytical study included 40 MASLD patients and 40 HV as controls. Established ED biomarkers, such as asymmetric dimethylarginine (ADMA) and cyclic guanosine monophosphate (cGMP), the oxidative stress marker 4-hydroxynonenal (HNE) and Nostrin, were measured using commercially available ELISA kits. Flow-mediated dilation (FMD) of the brachial artery was assessed non-invasively using ultrasonography (USG) to measure endothelial function.</p><p><strong>Results: </strong>Compared to HV, MASLD patients exhibited elevated serum levels of Nostrin (<i>p</i> < 0.0001). Similarly, serum levels of ADMA and cGMP were significantly higher in MASLD patients than in HV (<i>p</i> < 0.0001). Furthermore, FMD of the brachial artery was significantly reduced in MASLD patients compared to HV (<i>p</i> < 0.0001). Elevated NOSTRIN levels were positively correlated with lipid profiles and markers of ED, and negatively correlated with FMD. Notably, area under the curve (AUC) suggest that Nostrin demonstrates a strong performance in differentiating MASLD patients from healthy controls patients.</p><p><strong>Conclusion: </strong>These findings suggest that Nostrin may contribute to the vascular impairment observed in MASLD and thus, it holds potential as a novel biomarker for identifying and managing endothelial dysfunction in patients with MASLD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of intestinal metaplasia at the lesser curvature guides mapping biopsies strategy.","authors":"Mingjun Ma, Mingru Liu, Xiao Liang, Xiuli Zuo","doi":"10.1080/00365521.2025.2561058","DOIUrl":"https://doi.org/10.1080/00365521.2025.2561058","url":null,"abstract":"<p><strong>Aim: </strong>Guidelines advise performing standard 4-5 sites mapping biopsies during the initial endoscopic assessment of gastric cancer risk, which increases the clinical burden. Emerging image-enhanced endoscopy (IEE) has demonstrated high diagnostic accuracy. This study aims to evaluate whether endoscopic evaluation can guide the decision to perform mapping biopsies.</p><p><strong>Methods: </strong>A prospective cohort of patients underwent gastroscopy screening in a tertiary care setting, with endoscopic evaluation using white light imaging (WLI) and IEE. Mapping biopsies were performed on patients diagnosed with atrophic gastritis to assess the Operative Link on Gastritis Intestinal Metaplasia (OLGIM) staging. Multivariate logistic regression was used to assess the association of OLGIM stage III/IV. The diagnostic performance of intestinal metaplasia (IM) at the lesser curvature for identifying OLGIM stage III/IV was evaluated.</p><p><strong>Results: </strong>OLGIM staging was completed for 648 patients with atrophic gastritis. Grade 1 and grade 2 IM of the corpus lesser curvature were significantly associated with OLGIM stage III/IV, with odds ratios of 8.17 (95% CI: 3.58-19.95) and 11.56 (95% CI: 3.66-38.94), respectively (both <i>p</i> < 0.001). The negative likelihood ratio (NLR) for IM at the antral lesser curvature was approximately 0.00.</p><p><strong>Conclusions: </strong>In regions with limited clinical resources, priority should be given to the evaluation of IM at the lesser curvature. Patients with IM at the corpus lesser curvature are suggested to undergo mapping biopsies. In the absence of IM at the antral lesser curvature, mapping biopsies may be safely omitted.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}