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Rethinking routine mapping biopsies in gastric intestinal metaplasia: justification for endoscopic stratification
  1. Duc Trong Quach1,2,
  2. Toru Hiyama3,
  3. Gwang Ha Kim4,
  4. Takuji Gotoda5,
  5. Kentaro Sugano6
  1. 1Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
  2. 2Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, Vietnam
  3. 3Health Service Center, Hiroshima University, Higashihiroshima, Japan
  4. 4Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
  5. 5Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
  6. 6Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Tochigi, Japan
  1. Correspondence to Professor Duc Trong Quach, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City Faculty of Medicine, Ho Chi Minh City, Ho Chi Minh, Viet Nam; drquachtd{at}gmail.com

https://doi.org/10.1136/gutjnl-2024-333773

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    We read with great interest and would like to commend the informative paper by Dinis–Ribeiro et al on a world-unified approach to the management of gastric intestinal metaplasia (GIM).1 A crucial issue of this approach is to identify subjects with high-risk GIM. The authors suggest that this should involve performing nontargeted biopsies according to mapping protocol even when endoscopy does not suggest GIM lesions, in addition to targeted biopsies to areas of suspected GIM. We believe that a resource-sensitive approach should be considered, taking into account the very high prevalence of GIM in some regions as well as the robust evidence of endoscopy in detecting and stratifying the risk of GIM.

    First, the prevalence of GIM varies significantly worldwide and can reach 22.1% in some regions.2 In regions with a high prevalence of GIM, …

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    Footnotes

    • Contributors QDT contributed to the study’s conception and wrote the first draft. QDT, HT, KGH, GT and SK intensively reviewed and edited the manuscript. All authors approved the final version of the manuscript. QDT submitted the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.