{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T08:10:29Z","timestamp":1778227829702,"version":"3.51.4"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012401","name":"Beijing Science and Technology Planning Project","doi-asserted-by":"crossref","award":["Z221100007422079"],"award-info":[{"award-number":["Z221100007422079"]}],"id":[{"id":"10.13039\/501100012401","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Non-magnifying endoscopy remains the most essential tool for detecting early gastric cancer (EGC), but there is still a lack of widely accepted diagnostic methods. We established an optimized EGC detection protocol using non-magnifying gastroscopy-guided targeted biopsy of morphological suspicious lesions and evaluated its effectiveness.<\/jats:p>\n                  <jats:p>This study included 5738 participants across four medical centers in China. Targeted biopsies were performed on the following suspicious lesions for high-grade neoplasia (HGN) under screening non-magnifying gastroscopy: 1) ulcerative lesions; 2) esophagogastric junction reddish lesions outside the atrophic area; 3) pale or well-demarcated lesions outside the atrophic area, except polypoid lesions smaller than 5 mm; 4) elevated lesions with clear borders or uneven top within the atrophic area; and 5) flat\/depressed lesions with irregular borders or uneven surface or ocher color under narrow-band imaging (NBI) within the atrophic area. Sensitivity for detecting gastric HGN and the positive predictive value (PPV) of targeted biopsy were calculated.<\/jats:p>\n                  <jats:p>The targeted biopsy method demonstrated a sensitivity of 90.9% (50\/55, 95% confidence interval [CI] 83.1%-98.8%) and a PPV of 5.4% (50\/931, 95% CI 3.9%-6.8%) for diagnosing HGN on per-lesion assessment. Lesions that met the suspicious morphological criteria carried a significant risk to be HGNs, even after adjusting for age, sex, and other risk factors associated with gastric cancer (adjusted odds ratio = 42.03, 95% CI 11.14\u2013158.63, P &lt; 0.001).<\/jats:p>\n                  <jats:p>Targeted biopsy of suspicious lesions for HGN with non-magnifying gastroscopy can be used as a primary clue for detecting EGC.<\/jats:p>","DOI":"10.1055\/a-2781-6191","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:30:37Z","timestamp":1773707437000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Diagnostic value of non-magnifying gastroscopy followed by targeted biopsy for detection of early gastric cancer: Multicenter prospective study"],"prefix":"10.1055","volume":"14","clinical-trial-number":[{"clinical-trial-number":"chictr2200057062","registry":"10.18810\/chictr"}],"author":[{"given":"Fumei","family":"Yin","sequence":"first","affiliation":[{"name":"Senior Department of Gastroenterology, Chinese PLA General Hospital First Medical Center, Beijing, China"},{"name":"Department of Gastroenterology, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinwei","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Shanghai East Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianjun","family":"Di","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3411-4602","authenticated-orcid":false,"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lang","family":"Yang","sequence":"additional","affiliation":[{"name":"Senior Department of Gastroenterology, Chinese PLA General Hospital First Medical Center, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, China"},{"name":"Medical School of Chinese PLA, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingjie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilin","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changwei","family":"Duan","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianqiu","family":"Sheng","sequence":"additional","affiliation":[{"name":"Senior Department of Gastroenterology, Chinese PLA General Hospital First Medical Center, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, China"},{"name":"Medical School of Chinese PLA, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-1906","authenticated-orcid":false,"given":"Peng","family":"Jin","sequence":"additional","affiliation":[{"name":"Senior Department of Gastroenterology, Chinese PLA General Hospital First Medical Center, Beijing, China"},{"name":"Department of Gastroenterology, Chinese PLA General Hospital Seventh Medical Center, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1053\/j.gastro.2011.08.007","article-title":"Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer.","volume":"141","author":"Y 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Historical study in United Kingdom and Japan","volume":"21","author":"S Kono","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref16","doi-asserted-by":"publisher","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":"ref17","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1136\/gut.47.2.251","article-title":"The Vienna classification of gastrointestinal epithelial neoplasia","volume":"47","author":"RJ Schlemper","year":"2000","journal-title":"Gut"},{"key":"ref18","first-page":"9","article-title":"A screening strategy for early gastric cancer under high-definition gastroscopy","volume":"38","author":"J Peng","year":"2021","journal-title":"Chin J Dig Endosc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1053\/j.gastro.2018.04.026","article-title":"Endoscopic screening in Asian countries is associated with reduced gastric cancer mortality: A meta-analysis and systematic review","volume":"155","author":"X Zhang","year":"2018","journal-title":"Gastroenterology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"E1289","DOI":"10.1055\/a-0746-3449","article-title":"Green epithelium revealed by narrow-band imaging (NBI): a feature for practical assessment of extent of gastric cancer after H. pylori eradication","volume":"6","author":"K Yagi","year":"2018","journal-title":"Endosc Int Open"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1136\/gutjnl-2019-319631","article-title":"Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging","volume":"70","author":"N Yoshida","year":"2021","journal-title":"Gut"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1111\/den.14152","article-title":"Diagnostic ability of magnification endoscope with narrow-band imaging in screening esophagogastroduodenoscopy","volume":"34","author":"M Takinami","year":"2022","journal-title":"Dig Endosc"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1055\/s-0031-1291537","article-title":"A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions","volume":"44","author":"P Pimentel-Nunes","year":"2012","journal-title":"Endoscopy"},{"key":"ref24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0164339","article-title":"The implications of endoscopic ulcer in early gastric cancer: Can we predict clinical behaviors from endoscopy?","volume":"11","author":"YJ Lee","year":"2016","journal-title":"PloS one"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1111\/den.12093","article-title":"Current status of endoscopic diagnosis and treatment of superficial Barrett's adenocarcinoma in Asia-Pacific region","volume":"25","author":"K Goda","year":"2013","journal-title":"Dig Endosc"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1111\/den.12471","article-title":"Helicobacter pylori-negative gastric cancer: characteristics and endoscopic findings","volume":"27","author":"Y Yamamoto","year":"2015","journal-title":"Dig Endosc"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1159\/000487795","article-title":"Characterization of Helicobacter pylori-na\u00efve early gastric cancers","volume":"98","author":"A Yamada","year":"2018","journal-title":"Digestion"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1111\/den.12638","article-title":"Magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G)","volume":"28","author":"M Muto","year":"2016","journal-title":"Dig Endosc"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"6541","DOI":"10.1007\/s00464-024-11235-6","article-title":"A novel color-aided system for diagnosis of early gastric cancer using magnifying endoscopy with narrow-band imaging","volume":"38","author":"H Zhang","year":"2024","journal-title":"Surg Endosc"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1007\/s10120-014-0399-2","article-title":"Can we accurately diagnose minute gastric cancers (\u22645 mm)? 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