{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:40:01Z","timestamp":1776134401571,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004271","name":"Sapienza Universit\u00e0 di Roma","doi-asserted-by":"crossref","award":["Ateneo 2019-2020"],"award-info":[{"award-number":["Ateneo 2019-2020"]}],"id":[{"id":"10.13039\/501100004271","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002In autoimmune atrophic gastritis (AAG), associated with intestinal (IM) and\/or pseudopyloric metaplasia (PPM), endoscopic surveillance is recommended for gastric cancer risk mainly linked to IM. Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) reliably identifies IM, but has not been assessed in AAG. We aimed to assess the performance of EGGIM (index test) versus histology (reference test) of corpus IM in AAG.<\/jats:p><jats:p>\n          Patients and methods\u2002This was a cross-sectional study of 210 AAG patients undergoing surveillance gastroscopy with narrow-band imaging (NBI): corpus IM scored according to EGGIM, histology according to updated Sydney system, and morphological criteria.<\/jats:p><jats:p>\n          Results\u2002NBI identified corpus IM in 88.6\u200a% of AAG patients: EGGIM were 0, 1, 2, 3, 4 in 11.4\u200a%, 0.5\u200a%, 33.3\u200a%, 1.9\u200a%, and 52.9\u200a%, respectively. Histology identified corpus IM in 78.1\u200a% and PPM in 79.5\u200a% of patients. PPM was present with IM in 57.6\u200a% and without IM in 21.9\u200a% patients, 20.5\u200a% had IM without PPM. EGGIM, compared to histology, correctly classified 76.2\u200a% of patients, showing high sensitivity (91.5\u200a%, 95\u200a%CI 86.1\u201395.3). EGGIM correctly classified 93\u200a% of patients with IM without PPM, 90.9\u200a% with both metaplasias, and 21.7\u200a% with PPM without IM yielding low specificity (21.7\u200a%, 95\u200a%CI 10.9\u201336.4).<\/jats:p><jats:p>\n          Conclusions\u2002In AAG, EGGIM showed high accuracy and sensitivity identifying &gt;\u200a90\u200a% of patients with histological corpus IM. EGGIM overestimated IM when PPM without IM was present, yielding low specificity. These findings raise the question of whether in AAG, PPM and IM may display similar endoscopic features on NBI.<\/jats:p>","DOI":"10.1055\/a-1776-7628","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T22:30:20Z","timestamp":1649975420000},"page":"E434-E440","source":"Crossref","is-referenced-by-count":9,"title":["Endoscopic diagnosis of gastric intestinal metaplasia in patients with autoimmune gastritis using narrow-band imaging: does pseudopyloric metaplasia muddy the waters?"],"prefix":"10.1055","volume":"10","author":[{"given":"Emanuele","family":"Dilaghi","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Pivetta","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Pilozzi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sant\u2019Andrea Hospital, University Sapienza, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Annibale","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith","family":"Lahner","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Sciences and Translational Medicine, Sant\u2019Andrea Hospital, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s41572-020-0187-8","article-title":"Autoimmune gastritis","volume":"6","author":"M V Lenti","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/j.dld.2019.09.016","article-title":"Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]","volume":"51","author":"E Lahner","year":"2019","journal-title":"Dig Liver Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1038\/nrc.2017.68","article-title":"Metaplasia: tissue injury adaptation and a precursor to the dysplasia-cancer sequence","volume":"17","author":"V Giroux","year":"2017","journal-title":"Nat Rev Cancer"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/path.5066","article-title":"Pyloric metaplasia, pseudopyloric metaplasia, ulcer-associated cell lineage and spasmolytic polypeptide-expressing metaplasia: reparative lineages in the gastrointestinal mucosa","volume":"245","author":"J R Goldenring","year":"2018","journal-title":"J Pathol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1055\/a-0859-1883","article-title":"Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy, European Helicobacter and Microbiota Study Group, European Society of Pathology, and Sociedade Portuguesa de Endoscopia Digestiva guideline update 2019","volume":"51","author":"P Pimentel-Nunes","year":"2019","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1136\/gutjnl-2018-318126","article-title":"British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma","volume":"68","author":"M Banks","year":"2019","journal-title":"Gut"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1055\/a-1205-0570","article-title":"Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis","volume":"52","author":"M Rodr\u00edguez-Carrasco","year":"2020","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1136\/gutjnl-2019-320091","article-title":"Endoscopic grading of gastric intestinal metaplasia on risk assessment for early gastric neoplasia: can we replace histology assessment also in the West?","volume":"69","author":"P Marcos","year":"2020","journal-title":"Gut"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1055\/a-0808-3186","article-title":"Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study","volume":"51","author":"G Esposito","year":"2019","journal-title":"Endoscopy"},{"key":"ref10","first-page":"1161","article-title":"Classification and grading of gastritis. 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