Development of a prediction model for transformation of chronic atrophic gastritis to high-grade intraepithelial neoplasia based on Traditional Chinese Medicine syndrome patterns.

Objectives: To develop a risk prediction model for the transformation of chronic atrophic gastritis (CAG) to high-grade intraepithelial neoplasia (HGIN) based on Traditional Chinese Medicine (TCM) syndrome patterns.

Methods: Clinical data of 201 chronic atrophic gastritis patients who visited the Department of Gastroenterology at the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine and Dong'erhuan Branch between January 2022 and March 2023 were retrospectively analyzed, including 32 patients with HGIN (HGIN group) and 169 patients with moderate and severe chronic atrophic gastritis (non-HGIN group). The information of demographic characteristics, dietary habits, lifestyle factors, psychosocial factors, family history of tumors, medical history and comorbidities, long-term medication, endoscopic findings, histopathological examination results, as well as TCM syndrome types were collected. Potential HGIN risk factors of were screened using LASSO regression, and then significant risk factors for establishing an HGIN risk prediction model were identified using logistic regression analysis. The final model was visually presented using a nomogram, and its diagnostic performance was evaluated through receiver operating characteristic curve analysis.

Results: Spleen-stomach Qi deficiency was the most common TCM syndrome in both HGIN and non-HGIN groups. LASSO-logistic regression model analysis showed that heavy alcohol consumption (X1), syndrome of static blood in stomach collaterals (X2), low-grade intraepithelial neoplasia (X3), high-salt diet (X4), and age (X5) were independent risk factors related to the occurrence of HGIN, and the predictive model was I n P 1- P=2.159X1+2.23X2+1.664X3+2.07X4+0.122X5- 11.096. The model demonstrated good discriminative ability, calibration, and goodness-of-fit.

Conclusions: The TCM syndrome of static blood in stomach collaterals shows a certain correlation with the transformation from chronic atrophic gastritis to HGIN. The HGIN prediction model based on TCM syndrome patterns developed in the study demonstrates potential clinical application value.