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DOI: 10.1055/a-1776-7759
Gastric intestinal metaplasia: can we abandon random biopsies
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Gastric intestinal metaplasia (GIM) is a precancerous condition from which gastric cancer may develop. Usually after chronic Helicobacter pylori infection, damage to the stomach glands occurs, leading to gastric atrophy. In some cases, the substitution with intestinal tissue causes GIM that is the most reliable marker for the development of dysplasia and gastric cancer [1]. Genetic or familial factors aside, GIM, especially in its extensive form involving both the gastric antrum and body, is the phenotype considered to be high risk for neoplastic changes. Performing five random biopsies during white light gastroscopy, following the updated Sydney System [2], used to be the standard for the diagnosis and staging of GIM, as well as for other gastrointestinal conditions for which use of random biopsies performed during white light endoscopy are still widespread.
Publication History
Article published online:
14 April 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Correa P. Human gastric carcinogenesis: a multistep and multifactorial process – First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992; 52: 6735-6740
- 2 Dixon MF, Genta RM, Yardley JH. et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-1181
- 3 Pimentel-Nunes P, Libanio 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: 723-730
- 4 Rodríguez-Carrasco M, Esposito G, Libânio D. et al. Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis. Endoscopy 2020; 52: 1048-1065
- 5 Esposito G, Pimentel-Nunes P, Angeletti S. et al. Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study. Endoscopy 2019; 51: 515-521
- 6 Dias-Silva D, Pimentel-Nunes P, Magalhaes J. et al. The learning curve for narrow-band imaging in the diagnosis of precancerous gastric lesions by using web-based video. Gastrointest Endosc 2014; 79: 910-920 ; quiz 983-e911, 983 e914
- 7 Pimentel-Nunes P, Libânio D, Marcos-Pinto R. et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European society of gastrointestinal en- doscopy (ESGE), European helicobacter and microbiota study group (EHMSG), European society of pathology (ESP), and sociedade Portuguesa de endoscopia digestiva (SPED) guideline update 2019. Endoscopy 2019; 51: 365-388
- 8 Faknak N, Pittayanon R, Tiankanon K. et al. Performance status of targeted biopsy alone versus Sydney protocol by non-NBI expert gastroenterologist in gastric intestinal metaplasia diagnosis. Endosc Int Open 2022; 10: 273-279
- 9 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: 857-865
- 10 Castro R, Rodriguez M, Libânio D. et al. Reliability and accuracy of blue light imaging for staging of intestinal metaplasia in the stomach. Scand J Gastroenterol 2019; 54: 1301-1305
- 11 Dekker E, Houwen B, Puig I. et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 899-923
- 12 Houwen BBSL, Hassan C, Hazewinkel Y. et al. Methodological framework for development of competence standards for optical diagnosis in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2022; 54: 84-87