摘要：Background Most incidental gastric polyps identified during upper endoscopy are considered ***,current guidelines recommend sampling all gastric polyps for histopathologic *** aimed to devise a simple narrow-band imaging(NBI)classification to reduce the need for routine biopsies of low-risk gastric *** Pairs of NBI and white-light images were collected from 73 gastric polyps for which concurrent histopathologic diagnosis was available.A diagnostic accuracy cohort study was *** blinded endoscopists independently analysed NBI features of each polyp for color,vessel pattern,surface pattern,and any combinations thereof to develop a classification scheme to differentiate low-risk polyps(fundic-gland or hyperplastic)from high-risk polyps(adenomatous or adenocarcinoma)and fundic-gland polyps(FGPs)from *** An isolated lacy vessel pattern and a homogenous absence of surface pattern successfully differentiated low-risk from high-risk gastric *** both descriptors into a single algorithm resulted in a negative predictive value(NPV)of 100%[95%confidence interval(CI):100%–100%],positive predictive value(PPV)of 13.7%(95%CI:2.6–24.8),sensitivity of 100%(95%CI:100%–100%),and specificity of 53.7%(95%CI:45.3%–62.0%)for high-risk *** would reduce the number of polyps requiring biopsy by 50%,while still capturing all high-risk *** FGPs,using a rule not to biopsy polyps with isolated lacy vessels resulted in a 94.9%NPV(95%CI:89.2%–100%),63.2%PPV(95%CI:47.2%–79.2%),94.8%sensitivity(95%CI:89.5%–100%),and 63.6%specificity(95%CI:51.3%–76.0%)for *** In this derivation cohort study,NBI is helpful for differentiating between high-risk and low-risk gastric polyps,thereby reducing the need for routine sampling of low-risk *** results need to be validated in a separate test population.