Abstract: Objective  To clarify the clinicopathological features of multiple white and flat elevated lesions（MWFLs） in the stomach and to explore the risk factors in affected individuals.
Methods  The subjects were 926 consecutive individuals undergoing endoscopy. The white light and narrow-band images of gastric mucosa were reviewed. The clinicopathological and endoscopic characteristics of multiple white and flat elevated lesions observed in the stomach were analyzed.
Results  The prevalence rate of MWFLs was 8.1%(75/926). The proportion of female and PPI use in the MWFLs positive group was higher than that in the MWFLs negative group(P＜0.05). The age in the MWFLs positive group was significantly higher than that in the MWFLs negative group(P＜0.05). There was no significant difference between two groups regarding H.P. status, atrophy, and the duration of PPI use(P＞0.05). The pathological Results   of MWFLs were chronic mucosa inflammation and gastric fundus epithelium hyperplasia, but no intestinal metaplasia and atrophy were observed.With the following risk factors identified on a logistic regression analysis: use of proton pump inhibitors, odds ratio （OR=1.951, 95%CI:1.052-3.613), female sex(OR=2.112, 95%CI:1.180-3.762), and older age(>55 years) （OR=2.541, 95%CI: 1.400-4.611）were risk factors for MWFLs.
Conclusion  Long-term use of PPIs ,female sex and age are risk factrors for MWFLs, and hyperplastic changes of the foveolar epithelium in the fundic glands is observed. We believe that endoscopists should recongize these lesions,and these lesions are not intestinal metaplasia.

Key words: multiple white and flat elevated lesions, stomach, proton pump inhibitor, helicobacter pylori