Gastric epithelial dysplasia: How clinicopathologic background relates to management

M. Rugge, G. Leandro, F. Farinati, F. Di Mario, F. Sonego, M. Cassaro, M. Guido, V. Ninfo

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Gastric epithelial dysplasia (GED) in metaplastic mucosa is considered the most advanced preinvasive lesion in the multistep morphogenesis of intestinal-type gastric cancer (GC). The rate of GED's evolution into GC is still under debate and probably is related to pathologic and clinical parameters other than the dysplasia itself. The aim of this study was to evaluate whether clinical aspects (sex and age) and/or morphologic variables (GED grade, coexisting atrophic gastritis) are relevant to the outcome of dysplasia, with a view toward initiating the establishment of a rational follow-up protocol for practical GED management. Methods. Ninety-three patients harboring GED (G1: 56, G2:34, G3:18) were followed for more than 12 months according to a previously-agreed protocol. Regression, progression, or evolution into GC were detected for each grade of GED. Multivariate analysis was used hi check the independence of clinical and pathologic variables in the progression of GED into more severe dysplastic lesions and/or as risk factors for evolution into GC. Results. Age, male sex, GED grade and grade of coexisting atrophic gastritis proved independent risk factors for GED progression, with no significant interactions. Only GED grade (G2 and G3) was significantly associated with carcinomatous evolution. In G1- GED, age and the grade of coexisting atrophy proved to be independent risk factors for carcinomatous evolution. Conclusions. In G1-GED, more stringent follow-up should be recommended for older patients with coexisting high grade atrophic gastritis; stringent follow-up is always mandatory for G2-GED; and a surgical approach is justified in G3-GED.

Original languageEnglish
Pages (from-to)376-382
Number of pages7
JournalCancer
Volume76
Issue number3
DOIs
Publication statusPublished - 1995

Keywords

  • atrophic gastritis
  • dysplasia management
  • gastric dysplasia
  • Helicobacter pylori

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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