{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T05:51:40Z","timestamp":1785563500535,"version":"3.56.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Gastric intestinal metaplasia (IM) can lead to gastric cancer. Until now, there have been limited studies of predictors for regression and progression of IM. This study aimed to determine risk factors associated with regression or progression of IM for guiding proper management and prevention of gastric cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>2,025 patients undergoing gastroscopy in Thammasat University Hospital, Thailand were enrolled during September 2017-August 2019. Patients\u2019 data including baseline characteristics, laboratory results, and histopathology of gastric biopsies from University medical database were extensively reviewed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>2,025 patients had mean age of 61.3 years and 44.2% were males. Overall <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> prevalence was 47.5%. There were 1,551(76.6%) patients with chronic gastritis and 361(17.8%) with IM. Of 400 patients with chronic gastritis having follow-up endoscopy and repeated gastric biopsies, 104(26%) had persistent <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection and 27(26%) developed IM during mean follow-up time of 24 months. Persistent <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection was significantly associated with development of IM (OR 3.16, 95%CI 1.56\u20136.39, p = 0.001). Regression, persistence, and progression of IM were demonstrated in 57.3%, 39.2%, and 3.5% of patients, respectively. Age &gt;65 years, persistent <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection, and diabetes mellitus were significantly associated with persistent IM or progression to dysplasia with OR 2.47(95%CI 1.33\u20134.61, p = 0.004), OR 2.64(95%CI 1.13\u20136.18, p = 0.025), and OR 2.54(95%CI 1.16\u20135.54, p = 0.019), respectively. Patients without <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection had more IM regression than patients with persistent infection (60.4%vs.39.4%, p = 0.035). Patients with persistent <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection significantly had higher IM progression to dysplasia (15.2%vs.2.1%; OR 11.15, 95%CI 1.18\u2013105.24, p = 0.035) than noninfected. During 24 months of study, 30 patients (1.5%) were diagnosed with gastric cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Regression of IM could be achieved by successful <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> eradication. Persistent <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection was significantly associated with development and progression of IM to dysplasia. Age &gt;65 years and diabetes mellitus were also significant predictors for IM progression.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255601","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T17:27:59Z","timestamp":1628702879000},"page":"e0255601","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial)"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6496-0284","authenticated-orcid":true,"given":"Natsuda","family":"Aumpan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratha-korn","family":"Vilaichone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bubpha","family":"Pornthisarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soonthorn","family":"Chonprasertsuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9842-3025","authenticated-orcid":true,"given":"Sith","family":"Siramolpiwat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patommatat","family":"Bhanthumkomol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongjarat","family":"Nunanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navapan","family":"Issariyakulkarn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarita","family":"Ratana-Amornpin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Miftahussurur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varocha","family":"Mahachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,11]]},"reference":[{"issue":"3","key":"pone.0255601.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"pone.0255601.ref002","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/S2468-1253(19)30328-0","article-title":"The global, regional, and national burden of stomach cancer in 195 countries, 1990\u20132017: a systematic analysis for the Global Burden of Disease study 2017","volume":"5","author":"A Etemadi","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"pone.0255601.ref003","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: diffuse and co-called intestinal-type carcinoma. 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