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, …

中文翻译：

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重新思考胃肠化生常规活检活检：内镜分层的合理性


我们怀着极大的兴趣阅读并赞扬 Dinis–Ribeiro 等人关于胃肠化生 (GIM) 治疗的世界统一方法的内容丰富的论文。1 这种方法的一个关键问题是识别具有高风险 GIM。作者建议，除了对疑似 GIM 区域进行靶向活检外，即使内窥镜检查未提示 GIM 病变，也应根据标测方案进行非靶向活检。我们认为，考虑到某些地区 GIM 的患病率非常高，以及内窥镜检查在检测和分层 GIM 风险方面的有力证据，应考虑采取资源敏感的方法。首先，GIM 的患病率在世界范围内差异很大，在某些地区可达 22.1%。2 在 GIM 患病率较高的地区，……