title: Anatomical predilection of intestinal metaplasia based on 78,335 endoscopic cases.
abstract: OBJECTIVE
  Gastric intestinal metaplasia (IM) is an important risk factor for intestinal-type gastric carcinoma, and successful treatment critically depends on its timely detection. In order to guide appropriate endoscopic surveillance, objective knowledge on the anatomical predilection of intestinal metaplasia development is urgently needed.
  
  
  METHODS
  A total of 78,335 cases who underwent gastroduodenoscopy from 2008 to 2013 in Jiangsu and Anhui provinces in China, were studied. Demographic and clinical characteristics, as well as biopsy location and histological results, were analyzed.
  
  
  RESULTS
  This study revealed that intestinal metaplasia incidence was 28.5% in angulus, 20.24% in lesser curvature of the antrum, and 25.48% in corpus; and all these were significantly higher than those observed in other sites (P < 0.01). Histological grading of intestinal metaplasia in the lesser curvature of the antrum and angulus was generally worse than the grading observed in the greater curvature of the antrum. For Helicobacter pylori-positive patients, acute inflammation was more severe in the lesser curvature of the antrum compared with the greater curvature. In the H. Pylori-negative group, both acute and chronic inflammations were more severe in the lesser curvature of the antrum.
  
  
  CONCLUSIONS
  The angulus, lesser curvature in the antrum, and corpus are most prone to the development of intestinal metaplasia. Inflammation is most severe in the lesser curvature of the antrum, which corresponds to a higher predilection to develop intestinal metaplasia at this site. The lesser curvature of the antrum and corpus require the most attention during endoscopic biopsy surveillance.
authors.forename: Xin-Yi
authors.initials: XY
authors.lastname: Mao
authors.forename: Shun-Fu
authors.initials: SF
authors.lastname: Xu
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jian-Xia
authors.initials: JX
authors.lastname: Jiang
authors.forename: Hai-Han
authors.initials: HH
authors.lastname: Zhang
authors.forename: Huai-Ming
authors.initials: HM
authors.lastname: Sang
authors.forename: Guo-Xin
authors.initials: GX
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002681:China / Q000453:epidemiology; D004384:Duodenoscopy / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D007422:Intestines / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D060787:Neoplasm Grading; D055815:Young Adult