Gastric Preneoplastic Lesions and Epithelial Dysplasia
Section snippets
Mucosal changes that precede gastric dysplasia
Epidemiological and morphological studies have demonstrated that intestinal gastric cancers usually are preceded by a sequence of histological events beginning with diffuse chronic gastritis and eventually leading to mucosal atrophy, intestinal metaplasia, and dysplasia [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]. H pylori infection is associated with the induction of chronic inflammation in gastric mucosa and with the progressive development of metaplastic changes [7]. In fact,
Gastric epithelial dysplasia
Evidence for GED as a direct precursor of gastric adenocarcinoma stems primarily from observations in surgically resected gastric cancers. In this setting, high-grade dysplasia has been identified in close proximity to 40% to 100% of early gastric cancers, and 5% to 80% of advanced adenocarcinomas [35], [36], [37]. Moreover, GED is also a marker of risk for cancer elsewhere in the gastric mucosa. Thus, GED is often present in the background mucosa distant from foci of adenocarcinoma, and
Summary
Despite the declining incidence of gastric cancer, it remains the second most common cause of cancer-related deaths worldwide. More than a decade after H pylori was designated as a definite carcinogen by the WHO, several key questions remain to be answered. Only a small minority of patients infected with H pylori eventually develops gastric cancer, and eradication of H pylori in these patients does not seem to eliminate the risk of cancer completely. The optimal surveillance strategy for
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Cited by (41)
Pathology and Clinical Relevance of Gastric Epithelial Dysplasia
2024, Gastroenterology Clinics of North AmericaNeoplastic precursor lesions of the upper gastrointestinal tract
2017, Diagnostic HistopathologyCitation Excerpt :Once a diagnosis of dysplasia is rendered, patients should undergo re-evaluation of the gastric mucosa with enhancing techniques and extensive mucosal sampling, as described in the updated Sydney system.79 Some authors have suggested that patients with low-grade dysplasia should be endoscopically re-evaluated every 12 months, whereas patients with high-grade dysplasia require careful staging followed by complete excision.77 Invasive carcinomas limited to the mucosa are infrequently associated with regional lymph node metastases and, thus, may be treated with local excision, provided that they are adequately staged pre-operatively.
Diagnostic Pathology: Gastrointestinal
2015, Diagnostic Pathology: GastrointestinalGastric Cancer
2014, Pathobiology of Human Disease: A Dynamic Encyclopedia of Disease MechanismsManagement of gastric polyps: An endoscopy-based approach
2013, Clinical Gastroenterology and HepatologyCitation Excerpt :No evidence-based guidelines exist; therefore, local recommendations should be followed when available. The most common gastric neoplastic polyp is an epithelial dysplastic growth still commonly referred to as an adenoma, despite the new nomenclature (raised intraepithelial neoplasia) suggested by the World Health Organization.44,45 In the Western industrialized world, H pylori–related sporadic gastric adenomas have become rare, accounting for less than 1% of all gastric polyps.