{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:26:42Z","timestamp":1791214002348,"version":"4.1.0"},"reference-count":19,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Shanghai Putuo District clinical characteristic disease construction project","award":["2023tszb01"],"award-info":[{"award-number":["2023tszb01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between gastric intestinal metaplasia severity grades, histological subtypes, and oncogenic potential remains unclear. This study explored gastric intestinal metaplasia (GIM) subtypes and c-Myc protein expression across mild, moderate, and severe GIM cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 180 paraffin-embedded gastroscopy biopsy samples from patients diagnosed with atrophic gastritis were selected, with 60 cases each of mild, moderate, and severe GIM. Alcian blue-Periodic acid-Schiff (AB-PAS) and high iron diamine (HID) staining were used to classify GIM into types I-III. Immunohistochemistry was performed to assess c-Myc expression, with low, moderate, and high expression defined as the percentage of c-Myc-positive cells in the GIM area of &lt;15%, 15\u201340%, and \u2265 40%, respectively. Spearman and Kruskal\u2013Wallis tests were used to analyze the correlation between GIM severity, GIM subtype, and c-Myc expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GIM was predominantly diagnosed in middle-aged and elderly individuals. Regarding the subtype, 53.89% were type II, 25.56% were type III, and 20.56% were type I. Low c-Myc expression was present in 47.78% of cases, moderate expression in 36.67%, and high expression in 15.56%. Neither the severity of GIM nor its subtype or c-Myc expression level was correlated with age or sex. Type III GIM accounted for approximately 10% of mild-to-moderate cases, whereas &gt; 50% of severe GIM cases were type III. A positive correlation was found between GIM severity and subtype (r\n                      <jats:sub>s<\/jats:sub>\n                      = 0.376,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). There was no significant correlation in c-Myc expression across different GIM severities. From type I to type III GIM, the proportion of low c-Myc expression increased and that of high expression decreased, whereas that of moderate expression remained almost unchanged. A negative correlation was observed between the GIM subtype and c-Myc expression (r\n                      <jats:sub>s<\/jats:sub>\n                      = \u22120.148,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GIM incidence increases with age; however, the histological severity of GIM (as defined by the extent of mucosal gland involvement) within a single biopsy sample does not show a corresponding increase with age. The more severe the GIM is, the greater the proportion of type III GIM cases present. c-Myc expression did not correlate with GIM severity. Conversely, as the GIM subtype becomes more advanced (from type I to type III), c-Myc expression decreases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20257","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:34:35Z","timestamp":1761899675000},"page":"e20257","source":"Crossref","is-referenced-by-count":1,"title":["Gastric intestinal metaplasia subtypes and the effects of c-Myc expression on severity"],"prefix":"10.7717","volume":"13","author":[{"given":"Qinglu","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine,  Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingzhi","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Pathology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingying","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine,  Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuewei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine,  Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"10.7717\/peerj.20257\/ref-1","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1080\/15384101.2019.1598725","article-title":"Dynamics of protein synthesis and degradation through the cell cycle","volume":"18","author":"Alber","year":"2019","journal-title":"Cell Cycle"},{"key":"10.7717\/peerj.20257\/ref-2","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"10.7717\/peerj.20257\/ref-3","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1016\/j.gie.2009.12.029","article-title":"The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis","volume":"71","author":"Capelle","year":"2010","journal-title":"Gastrointestinal Endoscopy"},{"key":"10.7717\/peerj.20257\/ref-4","doi-asserted-by":"publisher","first-page":"3442","DOI":"10.1007\/s10620-010-1189-2","article-title":"Narrow band imaging for the detection of gastric intestinal metaplasia and dysplasia during surveillance endoscopy","volume":"55","author":"Capelle","year":"2010","journal-title":"Digestive Diseases and Sciences"},{"key":"10.7717\/peerj.20257\/ref-5","first-page":"3554","article-title":"A human model of gastric carcinogenesis","volume":"48","author":"Correa","year":"1988","journal-title":"Cancer Research"},{"key":"10.7717\/peerj.20257\/ref-6","doi-asserted-by":"publisher","first-page":"3205","DOI":"10.1038\/s41467-023-39016-0","article-title":"Spatiotemporal transcriptomic atlas reveals the dynamic characteristics and key regulators of planarian regeneration","volume":"14","author":"Cui","year":"2023","journal-title":"Nature Communications"},{"key":"10.7717\/peerj.20257\/ref-7","doi-asserted-by":"publisher","first-page":"13457","DOI":"10.1073\/pnas.1919507117","article-title":"MYC protein stability is negatively regulated by BRD4","volume":"117","author":"Devaiah","year":"2020","journal-title":"Proceedings of the National Academy of Sciences of the United States of America"},{"key":"10.7717\/peerj.20257\/ref-8","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1038\/s41571-021-00549-2","article-title":"The MYC oncogene\u2014the grand orchestrator of cancer growth and immune evasion","volume":"19","author":"Dhanasekaran","year":"2022","journal-title":"Nature Reviews Clinical Oncology"},{"key":"10.7717\/peerj.20257\/ref-9","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1097\/00000478-199610000-00001","article-title":"Classification and grading of gastritis. 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