Artificial intelligence for endoscopic correlates of Correa’s cascade in gastric precancerous lesions and early neoplasia

doi:10.4251/wjgo.123447

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Oct 15, 2026; 18(10): 123447
Published online Oct 15, 2026. doi: 10.4251/wjgo.123447

Artificial intelligence for endoscopic correlates of Correa’s cascade in gastric precancerous lesions and early neoplasia

Hon Ho Yu, In Neng Chan, Jin-Hui Wang, Ye-Ying Qin, In Weng Chan, Pak Kin Wong

Hon Ho Yu, Department of Gastroenterology, Kiang Wu Hospital, Macau 999078, China

In Neng Chan, Pak Kin Wong, Department of Biomedical Engineering, University of Macau, Macau 999078, China

Jin-Hui Wang, Ye-Ying Qin, Pak Kin Wong, Department of Electromechanical Engineering, University of Macau, Macau 999078, China

In Weng Chan, Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China

Co-first authors: Hon Ho Yu and In Neng Chan.

Author contributions: Yu HH and Chan IN contributed to collecting and critically reviewing the relevant literature, developing the scope and structure of the manuscript, drafting the initial manuscript, designing the figures and tables, synthesizing the key findings, and revising the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Wang JH, Qin YY, and Chan IW conducted the investigation and contributed to writing, review, and editing; Wong PK provided supervision, project administration, and funding acquisition; and all authors read and approved the final version of the manuscript.

AI contribution statement: ChatGPT 5.2 and ChatGPT 5.5 developed by OpenAI, were used solely for language polishing, grammar refinement, formatting assistance, and improvement of manuscript clarity.

Supported by the Science and Technology Development Fund of Macau, No. 0026/2022/A.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Pak Kin Wong, PhD, Professor, Department of Biomedical Engineering, University of Macau, Avenida da Universidade, Taipa, Macau 999078, China. fstpkw@um.edu.mo

Received: May 19, 2026
Revised: July 21, 2026
Accepted: August 14, 2026
Published online: October 15, 2026
Processing time: 122 Days and 13.8 Hours

Core Tip

Core Tip: This article applies Correa’s cascade as a clinical framework for evaluating artificial intelligence (AI) in upper endoscopy. Rather than directly identifying biological progression, current AI systems recognize visible endoscopic phenotypes associated with gastritis, atrophy, intestinal metaplasia, dysplasia, and early gastric cancer. By integrating histopathology, endoscopic appearance, AI task design, reference standards, validation level, and clinical decision impact, this review demonstrates why high image-level accuracy may overestimate clinical utility. Future research should emphasize prospective, multicenter, video-based validation together with patient-level and procedure-level outcome assessment.