{"title":"内镜下胃肠化生分级（EGGIM）在评估胃肠化生的范围和程度中的作用。","authors":"Dong Lyu, Jing Zhao, Hai Feng Jin, Bin Lyu","doi":"10.1111/1751-2980.13346","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>We aimed to evaluate the consistency between endoscopic grading of gastric intestinal metaplasia (EGGIM) and the operative link on gastric intestinal metaplasia assessment (OLGIM) staging, as well as the value of endoscopic grading of gastric intestinal metaplasia (GIM) in early gastric cancer (EGC) risk.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The sample size was estimated to be at least 210 patients. To evaluate GIM, EGGIM staging was used during magnifying endoscopy with narrow-band imaging, while the OLGIM staging was carried out according to the updated Sydney system. The consistency between the two scoring systems and the accuracy of EGGIM in diagnosing OLGIM III/IV cases were evaluated. EGC risk was evaluated using the Kimura–Takemoto classification, the operative link on gastritis assessment (OLGA)/OLGIM, and EGGIM.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among the 210 patients, 68 (32.4%) had (previous) EGC and 142 (67.6%) had chronic atrophic gastritis (CAG). EGGIM and OLGIM staging showed good consistency (<i>κ</i> = 0.805, <i>U</i> = 12.620, <i>p</i> < 0.001) in diagnosing OLGIM III/IV GIM, with an area under the receiver operating characteristic curve for EGGIM of 0.95. Using a cut-off value of > 4, the sensitivity and specificity were 95.7% and 91.4%, respectively. The EGGIM score was higher in the EGC group than in the CAG group (4.93 vs. 3.92, <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>EGGIM shows good diagnostic performance and consistency with OLGIM, which can simplify endoscopic surveillance by reducing the need for biopsy. The EGGIM score is associated with EGC risk, and endoscopic surveillance is recommended for patients with EGGIM score > 4.</p>\n </section>\n </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"129-134"},"PeriodicalIF":2.3000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13346","citationCount":"0","resultStr":"{\"title\":\"The Role of Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) in Assessing the Extent and Degree of Gastric Intestinal Metaplasia\",\"authors\":\"Dong Lyu, Jing Zhao, Hai Feng Jin, Bin Lyu\",\"doi\":\"10.1111/1751-2980.13346\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>We aimed to evaluate the consistency between endoscopic grading of gastric intestinal metaplasia (EGGIM) and the operative link on gastric intestinal metaplasia assessment (OLGIM) staging, as well as the value of endoscopic grading of gastric intestinal metaplasia (GIM) in early gastric cancer (EGC) risk.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The sample size was estimated to be at least 210 patients. To evaluate GIM, EGGIM staging was used during magnifying endoscopy with narrow-band imaging, while the OLGIM staging was carried out according to the updated Sydney system. The consistency between the two scoring systems and the accuracy of EGGIM in diagnosing OLGIM III/IV cases were evaluated. EGC risk was evaluated using the Kimura–Takemoto classification, the operative link on gastritis assessment (OLGA)/OLGIM, and EGGIM.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among the 210 patients, 68 (32.4%) had (previous) EGC and 142 (67.6%) had chronic atrophic gastritis (CAG). EGGIM and OLGIM staging showed good consistency (<i>κ</i> = 0.805, <i>U</i> = 12.620, <i>p</i> < 0.001) in diagnosing OLGIM III/IV GIM, with an area under the receiver operating characteristic curve for EGGIM of 0.95. Using a cut-off value of > 4, the sensitivity and specificity were 95.7% and 91.4%, respectively. The EGGIM score was higher in the EGC group than in the CAG group (4.93 vs. 3.92, <i>p</i> < 0.001).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>EGGIM shows good diagnostic performance and consistency with OLGIM, which can simplify endoscopic surveillance by reducing the need for biopsy. 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引用次数: 0
摘要
目的：评价内镜下胃肠化生分级（EGGIM）与手术环节对胃肠化生分级（OLGIM）分期的一致性，以及内镜下胃肠化生分级（GIM）在早期胃癌（EGC）风险中的价值。方法：样本量估计至少为210例患者。为了评估GIM，在窄带放大内镜下使用EGGIM分期，而OLGIM分期根据更新的Sydney系统进行。评价两种评分系统的一致性及EGGIM诊断OLGIM III/IV型病例的准确性。采用Kimura-Takemoto分级、胃炎手术环节评估(OLGA)/OLGIM和EGGIM评估EGC风险。结果：210例患者中有（既往）EGC 68例（32.4%），慢性萎缩性胃炎142例（67.6%）。EGGIM与OLGIM分期一致性较好（κ = 0.805, U = 12.620, p = 4），敏感性95.7%，特异性91.4%。EGC组EGGIM评分高于CAG组（4.93比3.92,p）结论：EGGIM与OLGIM具有良好的诊断性能和一致性，可以通过减少活检来简化内镜监测。EGGIM评分与EGC风险相关，建议对EGGIM评分为bb40的患者进行内镜监测。
The Role of Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) in Assessing the Extent and Degree of Gastric Intestinal Metaplasia
Objectives
We aimed to evaluate the consistency between endoscopic grading of gastric intestinal metaplasia (EGGIM) and the operative link on gastric intestinal metaplasia assessment (OLGIM) staging, as well as the value of endoscopic grading of gastric intestinal metaplasia (GIM) in early gastric cancer (EGC) risk.
Methods
The sample size was estimated to be at least 210 patients. To evaluate GIM, EGGIM staging was used during magnifying endoscopy with narrow-band imaging, while the OLGIM staging was carried out according to the updated Sydney system. The consistency between the two scoring systems and the accuracy of EGGIM in diagnosing OLGIM III/IV cases were evaluated. EGC risk was evaluated using the Kimura–Takemoto classification, the operative link on gastritis assessment (OLGA)/OLGIM, and EGGIM.
Results
Among the 210 patients, 68 (32.4%) had (previous) EGC and 142 (67.6%) had chronic atrophic gastritis (CAG). EGGIM and OLGIM staging showed good consistency (κ = 0.805, U = 12.620, p < 0.001) in diagnosing OLGIM III/IV GIM, with an area under the receiver operating characteristic curve for EGGIM of 0.95. Using a cut-off value of > 4, the sensitivity and specificity were 95.7% and 91.4%, respectively. The EGGIM score was higher in the EGC group than in the CAG group (4.93 vs. 3.92, p < 0.001).
Conclusions
EGGIM shows good diagnostic performance and consistency with OLGIM, which can simplify endoscopic surveillance by reducing the need for biopsy. The EGGIM score is associated with EGC risk, and endoscopic surveillance is recommended for patients with EGGIM score > 4.
期刊介绍：
The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.
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