Atypias, dysplasias, and neoplasias of the esophagus and stomach.
Our understanding of the origin and evolution of gastrointestinal mucosal dysplasias and neoplasias has been greatly expanded in recent years by the marked increase in the number of endoscopic biopsies, which are facilitated by the use of flexible instruments with a remarkable safety record. The availability of specimens and the development of special procedures to examine them allows the detailed study of the normal and abnormal gastrointestinal mucosa, as determined by histochemical procedures. Similarly, immunocytochemistry has been used to determine the presence of oncofetal antigens as an expression of neoplastic transformation and/or evolution. Finally, the ease of repeat endoscopic procedures has permitted close observation of the natural or therapeutically modified history of mucosal lesions. The majority of the pathologic findings were in specimens obtained during endoscopic procedures ("grasp or pinch biopsies"), which generally yield superficial fragments of mucosa. Suction biopsies have been recently proposed as an alternative since such specimens contain portions of the whole mucosal layer and part of the submucosa. Our institution performs over 3,000 endoscopic procedures per year; the experience gathered with this material constitutes the basis for this review of esophageal and gastric preneoplastic and neoplastic mucosal lesions obtained by endoscopic and suction biopsies. Data obtained from conventional surgical specimens are also included.
D000230:Adenocarcinoma / Q000473:pathology; D001471:Barrett Esophagus / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D011178:Postgastrectomy Syndromes / Q000473:pathology; D011230:Precancerous Conditions / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology*