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Risk factors for intestinal metaplasia in a southeastern Chinese population: an analysis of 28,745 cases

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To identify risk factors for intestinal metaplasia in a southeastern Chinese population.


Subjects who underwent upper GI endoscopy and endoscopic biopsy in the First Affiliated Hospital of Nanjing Medical University from 2008 to 2013 were included into this study. Various demographic, geographic, clinical and pathological data were analyzed separately to identify risk factors for intestinal metaplasia.


The incidence of intestinal metaplasia differed significantly in 17 municipal areas ranging from 16.79 to 38.56% and was positively correlated with the age range of 40–70 years, male gender, gastric ulcer, bile reflux, Helicobacter pylori infection, atrophic gastritis, dysplasia, gastric cancer, degree of chronic and acute inflammation, and gross domestic product per capita (P < 0.01). Multivariate linear regression analysis indicated that only gross domestic product per capita revealed a significant difference in the incidence of intestinal metaplasia among all factors mentioned.


This study confirms age, male gender, gastric ulcer, bile reflux, H. pylori infection, severe degree of chronic and acute inflammation to be the risk factors for intestinal metaplasia. We speculate that the gross domestic product per capita of different areas may be a potential independent risk factor impacting the incidence of intestinal metaplasia.

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Fig. 1
Fig. 2



Intestinal metaplasia


Gastric cancer


Atrophic gastritis

H. pylori :

Helicobacter pylori


Endoscopy Information System


Odds ratio


Gastric ulcer


Duodenal ulcer


Chronic inflammation


Acute inflammation


Number of lymphoid follicle


Gross domestic product


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This work was supported by the National Natural Science Foundation of China (No. 81101800), the 12th Six Talents Peak Project of Jiangsu Province (No. 2015-WSN-028), the Research Project of Education Science in the 12th Five Year Plan of Nanjing Medical University (No. NY2222015030) and the Research Project of Chinese Medical Association & Chinese High Education Association (No. 2016B-KC019).

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Correspondence to Shun-Fu Xu.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Jian-Xia Jiang and Qing Liu have contributed equally to this work.

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Jiang, J., Liu, Q., Zhao, B. et al. Risk factors for intestinal metaplasia in a southeastern Chinese population: an analysis of 28,745 cases. J Cancer Res Clin Oncol 143, 409–418 (2017).

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  • Intestinal metaplasia
  • Risk factors
  • Helicobacter pylori infection
  • Inflammation
  • Gross domestic product per capita