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World J Gastroenterol. Dec 7, 2026; 32(45): 123704
Published online Dec 7, 2026. doi: 10.3748/wjg.123704
Published online Dec 7, 2026. doi: 10.3748/wjg.123704
Narrow-band imaging-modified Kyoto score predicts pathological upgrading after endoscopic submucosal dissection in gastric intraepithelial neoplasia
Tao Chen, An-Qiang Feng, Department of Gastroenterology, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou 221009, Jiangsu Province, China
Wei-Feng Zhang, Ni-Yi Dang, Feng Ye, Guo-Xin Zhang, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Co-first authors: Tao Chen and An-Qiang Feng.
Author contributions: Chen T and Zhang GX designed the research study; Chen T, Feng AQ, Zhang WF, Dang NY, and Ye F performed the research and collected the data; Chen T and Feng AQ analyzed the data and they contributed equally to this manuscript as co-first authors; Chen T drafted the manuscript; Zhang GX supervised the study. All authors have read and approved the manuscript.
AI contribution statement: ChatGPT was used during manuscript revision for language refinement, formatting assistance, structural organization, and preparation of responses to reviewers. It was not used for study design, data generation, or statistical analysis. All AI-assisted content was reviewed and verified by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82470593; and General Project of the Development Fund of the Affiliated Hospital of Xuzhou Medical University, No. XYFM202334.
Institutional review board statement: Ethical approval for the study protocol was granted by the Institutional Review Board of Xuzhou Central Hospital Affiliated to Southeast University (approval No. XZXY-LK-20191223-0156).
Clinical trial registration statement: This prospective observational cohort study did not involve assignment of participants to an intervention and was not registered as an interventional clinical trial.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Guo-Xin Zhang, PhD, Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. nanjingmedical@163.com
Received: May 29, 2026
Revised: July 10, 2026
Accepted: July 28, 2026
Published online: December 7, 2026
Processing time: 141 Days and 22.8 Hours
Revised: July 10, 2026
Accepted: July 28, 2026
Published online: December 7, 2026
Processing time: 141 Days and 22.8 Hours
Core Tip
Core Tip: This prospective study evaluated a narrow-band imaging-magnifying endoscopy-modified Kyoto Gastritis Score for predicting pathological upgrading after endoscopic submucosal dissection in gastric intraepithelial neoplasia. The modified score replaces white-light assessment of intestinal metaplasia with narrow-band imaging-magnifying endoscopy features, improving discrimination over the conventional score (area under the curve: 0.862 vs 0.769) and remaining independently associated with upgrading. A cutoff of ≥ 4 provided a negative predictive value of 83.22%, supporting low-risk identification and surveillance planning across Helicobacter pylori infection subgroups, although multicenter validation remains necessary.