{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:45:03Z","timestamp":1792395903425,"version":"4.4.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>\n                      The risk of gastric cancer (GC) following\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (HP) eradication has gained increasing attention. Map-like redness (MLR) is an easily recognizable and highly specific endoscopic feature observed after eradication. We aimed to quantify the association between MLR and the risk of GC and high-risk precancerous lesions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search in PubMed, Embase, the Cochrane Library, CNKI, Wanfang, CBM, and VIP databases up to April 23, 2025. The primary outcome was GC, and secondary outcomes were high-risk precancerous lesions defined as the Operative Link on Gastritis Assessment (OLGA) stage &amp;gt; II, Gastric Intestinal Metaplasia Assessment (OLGIM) stage &amp;gt; II, and Kimura\u2013Takemoto (K-T) classification &amp;gt; C2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      14 studies were included (10 for GC, 2 for OLGA, 3 for OLGIM, and 3 for K\u2013T classification). A significant association was observed between MLR and GC (ORs 4.38; 95% CI 3.45\u20135.57; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). MLR was also strongly associated with high-risk precancerous lesions: OLGA stage &amp;gt; II (ORs 10.45; 95% CI 5.98\u201318.25; I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0= 9.6%), OLGIM stage &amp;gt; II (ORs 10.78; 95% CI 2.02\u201357.60; I\n                      <jats:sup>2<\/jats:sup>\n                      = 94.0%), and K-T classification &amp;gt; C2 (ORs 4.65; 95% CI 2.62\u20138.25; I\n                      <jats:sup>2<\/jats:sup>\n                      = 19.3%). Subgroup analyses by region, study design, time direction, and\n                      <jats:italic>H. pylori<\/jats:italic>\n                      eradication status yielded consistent results (ORs range: 3.77-5.55), and leave-one-out sensitivity analyses showed stable estimates (ORs range: 4.15-4.69), confirming the robustness of the findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MLR is highly associated with an increased risk of GC and high-risk precancerous lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD420251048039<\/jats:ext-link>\n                      , identifier CRD420251048039.\n                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Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochi","family":"Ma","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, The First Affiliated Hospital, Henan University of Chinese Medicine","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyun","family":"Zou","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liju","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Li","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinglin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Li","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Dongzhimen Hospital, 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