{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:19:11Z","timestamp":1788265151759,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003995","name":"Natural Science Foundation of Anhui Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003995","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the risk factors and construct a prediction model of chronic atrophic gastritis (CAG) patients with intestinal metaplasia or dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The clinical data of 450 patients with CAG who were diagnosed and treated in the Department of Gastroenterology of the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2016 to February 2022 were collected. Single and multiple factors logistic regression analysis were used to explore the risk factors of intestinal metaplasia or dysplasia in patients of training cohort. Then, we constructed a model to predict the onset of intestinal metaplasia or dysplasia based on the data of training cohort, following which we tested the model in an external validation cohort of 193 patients from a local university teaching hospital. The ROC curve, calibration curve, and decision curve analysis were used to evaluate the accuracy of the prediction model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic>(<jats:italic>H. pylori<\/jats:italic>, HP) infection, pepsinogen I, gastrin-17, and the number of lesions were found to be independent rick factors of the model. The liner prediction model showed excellent predictive value in both training cohort and validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HP infection, pepsinogen I, gastrin-17, and the number of lesions are independent risk factors for intestinal metaplasia or dysplasia in patients with CAG. The prediction model constructed based on these factors has a high accuracy and excellent calibration, which can provide a great basis for condition assessment and individualized treatment of the patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.912331","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T05:10:12Z","timestamp":1652850612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk Factors Analysis and Prediction Model Establishment of Intestinal Metaplasia or Dysplasia in Patients With Chronic Atrophic Gastritis: A Multi-Center Retrospective Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Bei","family":"Pei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziang","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinglin","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2651037","DOI":"10.1155\/2019\/2651037","article-title":"Weiqi decoction attenuated chronic atrophic gastritis with precancerous lesion through regulating microcirculation disturbance and HIF-1\u03b1 signaling pathway.","volume":"2019","author":"Yin","year":"2019","journal-title":"Evid Based Complement Alternat Med."},{"key":"B2","first-page":"6735","article-title":"Human gastric carcinogenesis: a multistep and multifactorial process\u2013First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention.","volume":"52","author":"Correa","year":"1992","journal-title":"Cancer Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1136\/gut.2007.127167","article-title":"Epidemiological trends of pre-malignant gastric lesions: a long-term nationwide study in the Netherlands.","volume":"56","author":"de Vries","year":"2007","journal-title":"Gut."},{"key":"B4","doi-asserted-by":"publisher","first-page":"h3867","DOI":"10.1136\/bmj.h3867","article-title":"Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population.","volume":"351","author":"Song","year":"2015","journal-title":"BMJ."},{"key":"B5","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1080\/00365521.2018.1477987","article-title":"Occurrence of gastric cancer in patients with atrophic gastritis during long-term follow-up.","volume":"53","author":"Zhang","year":"2018","journal-title":"Scand J Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1111\/j.1365-2036.2005.02582.x","article-title":"Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection.","volume":"22","author":"Lahner","year":"2005","journal-title":"Aliment Pharmacol Ther."},{"key":"B7","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.autrev.2018.08.011","article-title":"The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective.","volume":"18","author":"Massironi","year":"2019","journal-title":"Autoimmun Rev."},{"key":"B8","author":"Raza","year":"2022","journal-title":"Atrophic Gastritis."},{"key":"B9","doi-asserted-by":"publisher","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":"Lahner","year":"2019","journal-title":"Dig Liver Dis."},{"key":"B10","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1615\/JEnvironPatholToxicolOncol.2018026839","article-title":"Chronic atrophic gastritis: a review.","volume":"37","author":"Li","year":"2018","journal-title":"J Environ Pathol Toxicol Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1016\/s0016-5085(71)80065-3","article-title":"Pepsinogens, pepsins, and pepsin inhibitors.","volume":"60","author":"Samloff","year":"1971","journal-title":"Gastroenterology."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e186","DOI":"10.1097\/MCG.0000000000000992","article-title":"Serum pepsinogen as a predictor for gastric cancer death: a 16-year community-based cohort study.","volume":"53","author":"Chiang","year":"2019","journal-title":"J Clin Gastroenterol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/apt.14248","article-title":"Systematic review with meta-analysis: diagnostic performance of the combination of pepsinogen, gastrin-17 and anti-Helicobacter pylori antibodies serum assays for the diagnosis of atrophic gastritis.","volume":"46","author":"Zagari","year":"2017","journal-title":"Aliment Pharmacol Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1136\/gutjnl-2018-317556","article-title":"Development and validation of a prediction rule for estimating gastric cancer risk in the Chinese high-risk population: a nationwide multicentre study.","volume":"68","author":"Cai","year":"2019","journal-title":"Gut."},{"key":"B15","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1443-9573.2007.00271.x","article-title":"Screening of atrophic gastritis and gastric cancer by serum pepsinogen, gastrin-17 and Helicobacter pylori immunoglobulin G antibodies.","volume":"8","author":"Cao","year":"2007","journal-title":"J Dig Dis."},{"key":"B16","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1093\/labmed\/lmab035","article-title":"Clinical value of pepsinogen in the screening, prevention, and diagnosis of gastric cancer.","volume":"53","author":"Han","year":"2022","journal-title":"Lab Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"652574","DOI":"10.3389\/fonc.2021.652574","article-title":"Diagnostic value of serum pepsinogen levels for screening gastric cancer and atrophic gastritis in asymptomatic individuals: a cross-sectional study.","volume":"11","author":"Tong","year":"2021","journal-title":"Front Oncol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"6894248","DOI":"10.1155\/2021\/6894248","article-title":"The diagnostic value of serum gastrin-17 and pepsinogen for gastric cancer screening in Eastern China.","volume":"2021","author":"Shen","year":"2021","journal-title":"Gastroenterol Res Pract."},{"key":"B19","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1111\/jgh.14646","article-title":"Chemoprevention of gastric cancer by Helicobacter pylori eradication and its underlying mechanism.","volume":"34","author":"Kim","year":"2019","journal-title":"J Gastroenterol Hepatol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2373","DOI":"10.3748\/wjg.v24.i22.2373","article-title":"Treatment of Helicobacter pylori infection in atrophic gastritis.","volume":"24","author":"Lahner","year":"2018","journal-title":"World J Gastroenterol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/s10654-010-9482-0","article-title":"Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies.","volume":"25","author":"Adamu","year":"2010","journal-title":"Eur J Epidemiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1046\/j.1365-2036.1999.00546.x","article-title":"Helicobacter pylori infection and gastric cancer: systematic review of the epidemiological studies.","volume":"13","author":"Danesh","year":"1999","journal-title":"Aliment Pharmacol Ther."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1002\/ijc.25476","article-title":"Incidence and risk factors for the development of chronic atrophic gastritis: five year follow-up of a population-based cohort study.","volume":"128","author":"Adamu","year":"2011","journal-title":"Int J Cancer."},{"key":"B24","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.3760\/cma.j.issn.0366-6999.20132494","article-title":"Relationship of Helicobacter pylori eradication with gastric cancer and gastric mucosal histological changes: a 10-year follow-up study.","volume":"127","author":"Zhou","year":"2014","journal-title":"Chin Med J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"546","DOI":"10.3109\/00365529609009126","article-title":"Long-term course and consequences of Helicobacter pylori gastritis. Results of a 32-year follow-up study.","volume":"31","author":"Valle","year":"1996","journal-title":"Scand J Gastroenterol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"142","DOI":"10.3109\/00365529109104001","article-title":"Grade of Helicobacter pylori colonisation in relation to gastritis: a six-year population-based follow-up study.","volume":"186","author":"Kekki","year":"1991","journal-title":"Scand J Gastroenterol Suppl."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1038\/ajg.2016.188","article-title":"Risks and predictors of gastric adenocarcinoma in patients with gastric intestinal metaplasia and dysplasia: a population-based study.","volume":"111","author":"Li","year":"2016","journal-title":"Am J Gastroenterol."},{"key":"B28","first-page":"4737","article-title":"Gastric precancerous process in a high risk population: cohort follow-up.","volume":"50","author":"Correa","year":"1990","journal-title":"Cancer Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4166\/kjg.2018.72.3.104","article-title":"[Reversibility of atrophic gastritis and intestinal metaplasia by eradication of Helicobacter pylori].","volume":"72","author":"Yoon","year":"2018","journal-title":"Korean J Gastroenterol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/apt.14424","article-title":"Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication - a prospective study for up to 10 years.","volume":"47","author":"Hwang","year":"2018","journal-title":"Aliment Pharmacol Ther."},{"key":"B31","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5009\/gnl.2012.6.1.21","article-title":"Evolutionary history of the Helicobacter pylori genome: implications for gastric carcinogenesis.","volume":"6","author":"Correa","year":"2012","journal-title":"Gut Liver."},{"key":"B32","doi-asserted-by":"publisher","first-page":"E311","DOI":"10.1055\/s-0034-1392090","article-title":"Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia.","volume":"3","author":"Kodama","year":"2015","journal-title":"Endosc Int Open."},{"key":"B33","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s10120-015-0462-7","article-title":"Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis.","volume":"19","author":"Chen","year":"2016","journal-title":"Gastric Cancer."},{"key":"B34","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s00535-009-0036-8","article-title":"Clinical prevention of gastric cancer by Helicobacter pylori eradication therapy: a systematic review.","volume":"44","author":"Ito","year":"2009","journal-title":"J Gastroenterol."},{"key":"B35","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1053\/j.gastro.2016.01.028","article-title":"Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis.","volume":"150","author":"Lee","year":"2016","journal-title":"Gastroenterology."},{"key":"B36","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3389\/fonc.2018.00326","article-title":"The association between metabolic syndrome and gastric cancer in Chinese.","volume":"8","author":"Li","year":"2018","journal-title":"Front Oncol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s10120-021-01222-4","article-title":"Association between triglyceride-glucose index and gastric carcinogenesis: a health checkup cohort study.","volume":"25","author":"Kim","year":"2022","journal-title":"Gastric Cancer."},{"key":"B38","doi-asserted-by":"publisher","first-page":"6829","DOI":"10.7150\/jca.35939","article-title":"Triglyceride-to-high density lipoprotein cholesterol ratio predicts clinical outcomes in patients with gastric cancer.","volume":"10","author":"Sun","year":"2019","journal-title":"J Cancer."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.912331\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T08:30:15Z","timestamp":1727253015000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.912331\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":38,"alternative-id":["10.3389\/fmed.2022.912331"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.912331","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,18]]},"article-number":"912331"}}