Comparison Of Different Risk Stratifications For Gastric Cancer And Establishing A Simplified Risk-scoring Model Based On The Kyoto Classification

ObjectiveAssessing the value of different risk stratifications in diagnosing early gastric cancer(GC)and exploring risk factors based on Kyoto gastritis classification.MethodsThis study included patients admitted in the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University from October 2021 to June2022 with gastroscopy.To evaluate the proportion of GC in each risk stratification of different methods and to compare the diagnostic performance of different methods using the receiver operating characteristic curve.Univariate and multivariate analyses were used to explore the correlation between endoscopic findings and GC.A simplified scoring system based on the Kyoto Classification of Gastritis was constructed using Nomogram plots to further explore the diagnostic efficacy and clinical value of the new scoring system.ResultsA total of 240 subjects were enrolled,and the diagnostic efficacy of the Kyoto classification score was similar to that of the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM),and the accuracy was higher than that of the Japanese scoring system and Operative Link for Gastritis Assessment(OLGA).Moderate atrophy(odds ratio [OR]= 3.52,95% confidence interval [CI]: 1.52-8.16),severe atrophy(OR=4.96,95% CI: 1.75-14.04),map-like redness(OR=9.89,95% CI: 1.16-84.15),and xanthelasma(OR=3.57,95% CI: 1.15-11.15)were independent risk factors for GC.The simplified Kyoto classification(AUROC=0.76)based on multivariate analysis demonstrated favorable diagnostic value compared to traditional Kyoto classification score(AUROC=0.74).ConclusionsThis study confirms the value of the Kyoto classification score and the OLGIM stage in the risk stratification of GC.Simplified Kyoto classification based on Kyoto gastritis classification is also promising in risk assessment of GC but still requires validation in the population.