Diagnosis and management of gastric dysplasia

• Published in: The Korean journal of internal medicine Vol. 31; no. 2; pp. 201 - 209
• Main Author: Sung, Jae Kyu
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.03.2016; 대한내과학회
• Subjects: Anti-Bacterial Agents - therapeutic use; Biopsy; Carcinoma in Situ - classification; Carcinoma in Situ - microbiology; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Disease Progression; Gastrectomy - adverse effects; Gastrectomy - methods; Gastric Mucosa - microbiology; Gastric Mucosa - pathology; Gastric Mucosa - surgery; Gastroscopy; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori - drug effects; Humans; Neoplasm Grading; Precancerous Conditions - classification; Precancerous Conditions - microbiology; Precancerous Conditions - pathology; Precancerous Conditions - surgery; Predictive Value of Tests; Review; Risk Factors; Stomach Neoplasms - classification; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Treatment Outcome; 내과학; Stomach; Dysplasia; Adenoma; Intraepithelial neoplasia
• ISSN: 2005-6648; 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2016.021

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.