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Diagnosis and management of gastric dysplasia

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Gastric dysplasia is a neoplastic lesion and a precursor of gastric cancer. The Padova, Vienna, and World Health Organization classifications were developed to overcome the discrepancies between Western and Japanese pathologic diagnoses and to provide a universally accepted classification of gastric epithelial neoplasia. At present, the natural history of gastric dysplasia is unclear. Much evidence suggests that patients with high-grade dysplasia are at high risk of progression to carcinoma or synchronous carcinoma. Therefore, endoscopic resection is required. Although patients with low-grade dysplasia have been reported to be at low risk of progression to carcinoma, due to the marked histologic discrepancies between forceps biopsy and endoscopic specimens, endoscopic resection for this lesion is recommended, particularly in the presence of other risk factors (large size; depressed gross type; surface erythema, unevenness, ulcer, or erosion; and tubulovillous or villous histology). Helicobacter pylori eradication in patients with dysplasia after endoscopic resection appear to reduce the incidence of metachronous lesions.

Abstract

Gastric dysplasia is a neoplastic lesion and a precursor of gastric cancer. The Padova, Vienna, and World Health Organization classifications were developed to overcome the discrepancies between Western and Japanese pathologic diagnoses and to provide a universally accepted classification of gastric epithelial neoplasia. At present, the natural history of gastric dysplasia is unclear. Much evidence suggests that patients with high-grade dysplasia are at high risk of progression to carcinoma or synchronous carcinoma. Therefore, endoscopic resection is required. Although patients with low-grade dysplasia have been reported to be at low risk of progression to carcinoma, due to the marked histologic discrepancies between forceps biopsy and endoscopic specimens, endoscopic resection for this lesion is recommended, particularly in the presence of other risk factors (large size; depressed gross type; surface erythema, unevenness, ulcer, or erosion; and tubulovillous or villous histology). Helicobacter pylori eradication in patients with dysplasia after endoscopic resection appear to reduce the incidence of metachronous lesions.

참고문헌 (61)

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관련 논문AI추천

Upgrade of Lesions Initially Diagnosed as Low-Grade Gastric Dysplasia upon Forceps Biopsy Following Endoscopic Resection권상옥, 김문영, 김재우, 김현수, 김혜정, 백순구, 석기태, 원찬식, 조미연거트앤리버 소화기연관학회협의회 · Gut and Liver2011 · 제5권 제2호Risk stratification of patients with gastric lesions indefinite for dysplasiaIl-Kwun Chung, Jae Kook Yang, Sang-Heum Park, Su Jung Han, Sun-Joo Kim, Tae Hoon Lee, Young Sin Cho, Yunho Jung대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제5호Negative pathology after endoscopic resection of gastric epithelial neoplasms: importance of pit dysplasia김광하, 김아롱, 김영금, 박도윤, 송근암, 이봉은, 이소정, 지준형, 황정수대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제4호Is Endoscopic Mucosal Resection a Sufficient Treatment for Low-Grade Gastric Epithelial Dysplasia?Beom Hee Kim, Beom Yong Yoon, Hee Seok Moon, Hyun Yong Jeong, Il Soon Jung, Jae Kue Sung, Kwang Hun Ko, Kyu Seop Kim, Seul Young Kim거트앤리버 소화기연관학회협의회 · Gut and Liver2012 · 제6권 제4호Clinical Outcomes of Endoscopic Resection for Low-Grade Dysplasia and High-Grade Dysplasia on Gastric Pretreatment Biopsy: Korea ESD Study Group백광호, 장재영, 전정원, Hong Su Jin, Jeon Seong Woo, Kim Chan Gyoo, Kim Soo Jin, Kim Sun-Moon, Lee Si Hyung, Lim Chul-Hyun, Park Jae Myung, Sung Jae Kyu거트앤리버 소화기연관학회협의회 · Gut and Liver2021 · 제15권 제2호Diagnosis and Management of High Risk Group for Gastric Cancer윤혁, 김나영거트앤리버 소화기연관학회협의회 · Gut and Liver2015 · 제9권 제1호

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