Abstract： Objective To discuss the clinical efficacy and factors influencing pathological upgrading in patients with gastric low-grade intraepithelial neoplasia(LGIN)undergoing endoscopic thermal therapy.Methods 98 patients with gastric LGIN were selected.All patients received endoscopic thermal therapy.The curative effect within 1 year after operation was ana-lyzed.According to the postoperative pathological differences,patients were classified into upgraded group and the non-upgraded group.Then the multivariate Logistic regression analysis was conducted to screen the influencing factors for pathological upgrading of LGIN patients after endoscopic thermal therapy.Results The cure rate was 82.65％at postoperative 12months,which was lower than 95.92％at postoperative 3 months,and the recurrence rate was 2.04％at postoperative 12months,which was higher than 11.11％at postoperative 3 months(P＜0.05).Univariate analysis denoted that postoperative pathological upgrading after endoscopic thermal therapy was not associated with age,gender,Helicobacter pylori infection,lesion color,and lesion location(P＞0.05),while was associated with lesion diameter,lesion morphology,surface ulcers,and spontaneous bleeding(P＜0.05).Mul-tivariate Logistic regression analysis suggested that lesion diameter≥2 cm,depressed type,presence of surface ulcers,and sponta-neous bleeding were independent risk factors for pathological upgrading after endoscopic thermal therapy in LGIN patients(P＜0.05).Conclusion Endoscopic thermal therapy is clinically effective in the treatment of LGIN,but patients have a high risk of postoperative pathological upgrading.Lesions diameter ≥ 2 cm,depressed type,presence of surface ulcers,and spontaneous bleed-ing are independent risk factors,so the active clinical interventions are needed in high-risk groups to reduce the chance of disease progression.