Long-term follow-up study of gastric intraepithelial neoplasias: progression from low-grade dysplasia to invasive carcinoma.
OBJECTIVE
A gastric intraepithelial neoplasia (IEN) is usually regarded as a precancerous lesion; however, the natural history of the gastric IEN has not been clarified. We aimed to evaluate the progression of dysplasia in gastric IENs.


METHODS
As a retrospective study, we reviewed 26 gastric adenomas with low-grade dysplasia (LGD) and one with high-grade dysplasia (HGD) from 18 patients. The patients were followed up for a median of 66 months from 1996 to 2004 (mean 58 months, 20-112 months) in Kyungpook National University Hospital. The histological diagnosis was classified according to the Vienna classification. We reviewed clinical (age and sex), morphological (size, color, shape, location in stomach, surface nodularity, and presence of the erosion), and histological (histological diagnosis, infection with Helicobacter pylori, infiltration of inflammatory cells, atrophy, intestinal metaplasia, microscopic erosions, and glandular appearance) characteristics with regard to progression of dysplasia.


RESULTS
We found eight IENs of progressive dysplasia (29.6%). One IEN with HGD and three IENs with LGD progressed to invasive adenocarcinoma (category 5). Four gastric IENs with LGD progressed to HGD (category 4). The clinical, morphological, and histological characteristics did not reveal any distinguishable features for progressive dysplasia.


CONCLUSIONS
For the potential risk of progressive dysplasia, gastric IENs should be treated actively using the recently advanced therapeutic endoscopic techniques, regardless of the degrees of dysplasia.
Park
Soo Young
SY
Department of Gastroenterology, Kyungpook National University College of Medicine, Junggu, Daegu, Korea.
Jeon
Seong Woo
SW
Jung
Min Kyu
MK
Cho
Chang Min
CM
Tak
Won Young
WY
Kweon
Young Oh
YO
Kim
Sung Kook
SK
Choi
Yong Hwan
YH
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000473:pathology* / Q000601:surgery; D012306:Risk; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery