Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2025; 17(3): 103296
Published online Mar 15, 2025. doi: 10.4251/wjgo.v17.i3.103296
Risk of progression to high-grade intraepithelial neoplasia and gastric cancer: A multi-center prospective study in Anhui Province, China
Ying-Ling Liu, Jie Liu, Ye-Tao Wang
Ying-Ling Liu, Jie Liu, Ye-Tao Wang, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Author contributions: Liu YL and Wang YT contributed to conceptualization, data curation, formal analysis, investigation, methodology; Liu J contributed to data curation, formal analysis; Wang YT contributed to supervision, visualization, review and editing.
Supported by the Research Project of the Chinese Digestive Early Cancer Physicians’ Joint Growth Program, No. GTCZ-2021-AH-34-0012.
Institutional review board statement: This study received approval from the Ethics Committee of Anhui Provincial Hospital (No. 2024-KY-372).
Clinical trial registration statement: This study is not registered.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Data, analytic methods, and study materials are available to other researchers upon request to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye-Tao Wang, MD, Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. wangyt96@163.com
Received: November 15, 2024
Revised: December 18, 2024
Accepted: January 2, 2025
Published online: March 15, 2025
Processing time: 92 Days and 5.7 Hours
Abstract
BACKGROUND

Gastric cancer is one of the most common cancers worldwide, especially in East Asia.

AIM

To explore the clinical outcomes and progression-related factors of low-grade intraepithelial neoplasia (LGIN) in the gastric mucosa and provide valuable guidance for improving treatment efficacy.

METHODS

A total of 357 patients diagnosed with LGIN based on initial pathological examination in Anhui Provincial Hospital or three other medical consortium units between January 2022 and June 2024 were included. Among them, 296 patients were followed up with endoscopic and biopsy pathology. Logistic regression was utilized to analyze the relevant risk factors for LGIN progression in the gastric mucosa.

RESULTS

The distribution sites of LGIN among the 357 patients were as follows: Gastric antrum (54.6%), gastric cardia (24.1%), gastric angulus (8.7%), gastric body (4.8%), gastric fundus (4.8%), and multiple sites (3.1%). Additionally, of the 357 patients with LGIN, 112 (31.4%) developed ulceration and 59 (16.5%) experienced gastric polyps. Furthermore, 231 of the 357 (64.71%) patients with LGIN tested positive for Helicobacter pylori (H. pylori) infection. The H. pylori infection rates of the patients with LGIN with accompanying atrophy, intestinal metaplasia, and gastric ulcer were 51.95%, 59.31%, and 28.57%, respectively. Multivariate logistic regression analysis showed that age ≥ 60 years [odds ratio (OR) = 3.063, 95% confidence interval (CI): 1.351-6.945, P = 0.007], H. pylori infection (OR = 3.560, 95%CI: 1.158-10.949, P = 0.027), multiple locations (OR = 10.136, 95%CI: 2.045-50.237, P = 0.005), lesion size ≥ 2 cm (OR = 3.921, 95%CI: 1.664-9.237, P = 0.002), and gastric ulcer (OR = 2.730, 95%CI: 1.197-6.223, P = 0.017) were predictive factors for LGIN progression.

CONCLUSION

LGIN progression is closely related to age, H. pylori positivity, multiple locations, lesion size ≥ 2 cm, and gastric ulcer. Thus, actively identifying these risk factors in patients with LGIN may have certain clinical significance in preventing further tumor progression.

Keywords: Low-grade intraepithelial neoplasia; Gastric cancer; Progression; Risk factor; Prospective study

Core Tip: Excessive endoscopic follow-up may increase the examination-related risks and treatment costs for patients at a low-risk stage. Therefore, identifying risk factors is necessary and provides practical clinical value in predicting and evaluating the likelihood of low-grade intraepithelial neoplasia (LGIN) progression. Here, we conducted a multi-center prospective study to investigate the risk factors associated with LGIN progression and to predict the prognosis of patients with LGIN for effectively identifying high-risk groups that may progress to gastric cancer.