Li YM, Guo WJ, Deng C, Luo J, Shi YF, Zhu D, Wei QL, Zhang MG, Du SY, Tan HY. Risk assessment of type I gastric neuroendocrine tumors based on endoscopic and clinical features of autoimmune gastritis. World J Gastroenterol 2025; 31(41): 111449 [DOI: 10.3748/wjg.v31.i41.111449]
Corresponding Author of This Article
Huang-Ying Tan, MD, PhD, Professor, Department of Integrative Oncology, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Beijing 100029, China. tanhuangying@zryhyy.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 7, 2025 (publication date) through Nov 9, 2025
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Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li YM, Guo WJ, Deng C, Luo J, Shi YF, Zhu D, Wei QL, Zhang MG, Du SY, Tan HY. Risk assessment of type I gastric neuroendocrine tumors based on endoscopic and clinical features of autoimmune gastritis. World J Gastroenterol 2025; 31(41): 111449 [DOI: 10.3748/wjg.v31.i41.111449]
World J Gastroenterol. Nov 7, 2025; 31(41): 111449 Published online Nov 7, 2025. doi: 10.3748/wjg.v31.i41.111449
Risk assessment of type I gastric neuroendocrine tumors based on endoscopic and clinical features of autoimmune gastritis
Yan-Mei Li, Wen-Juan Guo, Chao Deng, Jie Luo, Yan-Fen Shi, Dan Zhu, Qi-Lu Wei, Ming-Gang Zhang, Shi-Yu Du, Huang-Ying Tan
Yan-Mei Li, Wen-Juan Guo, Dan Zhu, Qi-Lu Wei, Ming-Gang Zhang, Shi-Yu Du, Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China
Chao Deng, Huang-Ying Tan, Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China
Jie Luo, Yan-Fen Shi, Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China
Co-first authors: Yan-Mei Li and Wen-Juan Guo.
Co-corresponding authors: Shi-Yu Du and Huang-Ying Tan.
Author contributions: Li YM and Guo WJ equally contributed to the design of the study, acquiring and analyzing data from experiments, and writing of the manuscript; Deng C, Shi YF, Zhu D, and Wei QL performed the research; Luo J and Zhang MG analyzed the data; Tan HY and Du SY equally contributed to the conceptualization and revision; all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the China-Japan Friendship Hospital Institutional Review Board, No. 2025-KY-108-1.
Informed consent statement: In consideration of the retrospective nature of the study and the minimal risk to participants, a waiver of informed consent was granted.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huang-Ying Tan, MD, PhD, Professor, Department of Integrative Oncology, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Beijing 100029, China. tanhuangying@zryhyy.com.cn
Received: July 2, 2025 Revised: August 4, 2025 Accepted: September 26, 2025 Published online: November 7, 2025 Processing time: 127 Days and 18.5 Hours
Abstract
BACKGROUND
Autoimmune gastritis (AIG) is frequently associated with one or more comorbid conditions, among which type I gastric neuroendocrine tumors (gNETs) warrant significant clinical concern. However, risk factors for the development of gNETs in AIG populations remain poorly defined.
AIM
To characterize the clinical and endoscopic profiles of AIG and identify potential risk factors for gNETs development.
METHODS
In this single-center cross-sectional study carried out at a tertiary hospital, 303 patients with AIG over an 8-year period were retrospectively categorized into gNETs (n = 116) and non-gNETs (n = 187) groups. Endoscopic and clinical parameters were analyzed. Endoscopic features were systematically reevaluated according to the 2023 Japanese diagnostic criteria for AIG. Feature selection was performed using the Boruta algorithm, and the model discriminative ability was evaluated via receiver operating characteristic curve analysis.
RESULTS
Among the 303 patients with AIG, 116 had gNETs and 187 did not. Compared with the non-gNETs group, patients in the gNETs group were younger (54.3 years vs 60.6 years, P < 0.001), had higher rate of vitamin B12 deficiency (77.2% vs 55.8%, P < 0.001), lower pepsinogen I (4.3 ng/mL vs 7.4 ng/mL, P < 0.001) and pepsinogen I/II ratios (0.7 vs. 1.1, P < 0.001), and lower prior Helicobacter pylori infection rate (3.4% vs 21.4%, P < 0.001). Endoscopically, the gNETs group showed a lower incidence of oxyntic mucosal remnants, hyperplastic polyps, and patchy antral redness. The predictive model incorporating age, prior Helicobacter pylori infection, vitamin B12 level, gastric hyperplastic polyps, and patchy antral redness showed an area under the curve of 0.830.
CONCLUSION
Patients with AIG or gNETs exhibit specific clinical and endoscopic features. The predictive model demonstrated favorable discriminative ability and may facilitate risk stratification of gNETs in patients with AIG.
Core Tip: To explore the potential risk factors for gastric neuroendocrine tumors (gNETs) in autoimmune gastritis, 303 patients (116 with and 187 without gNETs) were analyzed. Patients in gNETs group were younger, had a higher rate of vitamin B12 deficiency, lower pepsinogen I levels and pepsinogen I/II ratios, fewer prior Helicobacter pylori infections, oxyntic mucosal remnants, gastric hyperplastic polyps, and patchy antral redness. The features selected using the Boruta algorithm included age, Helicobacter pylori infection status, vitamin B12 level, gastric hyperplastic polyps, and patchy antral redness. The identified predictors may facilitate risk stratification of gNETs in patients with autoimmune gastritis.
