Optimal management of biopsy-proven low-grade gastric dysplasia.

Autor: Kim JW; Jung-Wook Kim, Jae Young Jang, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-702, South Korea., Jang JY; Jung-Wook Kim, Jae Young Jang, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-702, South Korea.
Jazyk: angličtina
Zdroj: World journal of gastrointestinal endoscopy [World J Gastrointest Endosc] 2015 Apr 16; Vol. 7 (4), pp. 396-402.
DOI: 10.4253/wjge.v7.i4.396
Abstrakt: Gastric adenocarcinoma generally culminates via the inflammation-metaplasia-dysplasia-carcinoma sequence progression. The prevalence of gastric adenomas shows marked geographic variation. Recently, the rate of diagnosis of low-grade dysplasia (LGD) has increased due to increased use of upper endoscopy. Many investigators have reported that gastric high-grade dysplasia has high potential for malignancy and should be removed; however, the treatment for gastric LGD remains controversial. Although the risk of LGD progression to invasive carcinoma has been reported to be inconsistent, progression has been observed during follow-up. Additionally, the rate of upgraded diagnosis in biopsy-proven LGD is high. Therefore, endoscopic resection (ER) may be useful in the treatment and diagnosis of LGD, especially if lesions are found to have risk factors for upgraded histology after ER, such as large size, surface erythema or depressed morphology. Fatal complications in endoscopic submucosal dissection (ESD) are extremely low and its therapeutic and diagnostic outcomes are excellent. Therefore, ESD should be applied preferentially instead of endoscopic mucosal resection.
Databáze: MEDLINE