Therapeutic Strategy for Gastric Epithelial Dysplasia

Min, Jin Sik; Noh, Sung Hoon; Kim, Ho Guen; Yoo, Chang Hak; Lee, Yong Chan

Abstract

BACKGROUND AND AIMS: The purposes of this retrospective study are to analyse the clinicopathological characteristics and treatment results of the gastric epithelial dysplasia (GED) and to establish a rational therapeutic strategy for GED.
METHODS
From 1993 to 1995, the 67 patients who were initially diagnosed as GED by examination of endoscopic biopsies were reviewed after categorizing according to Morson's classification as mild (G1, n=10), moderate (G2, n=31), and severe (G3, n=26) GED.
RESULTS
Dysplastic changes were not detectable at follow-up in 60% of G1 cases and 13.8% of G2 cases. Endoscopic mucosal resection was performed in a total of 30 cases: 2 in G1, 19 in G2, and 9 in G3 and the results were fine except 5 cases of recurrence or positive resection margin. Gastrectomy was performed in 30 cases: 2 in G1, 19 in G2, and 9 in G3. Gastric cancer was detected in 21 cases. The 20 cases of them were at early stage (early gastric cancer) and 1 case was at advanced stage. In addition, lymph node metastasis was found only in 1 case of submucosal cancer.
CONCLUSIONS
The therapeutic strategy for GED, especially in high grade, might be endoscopic mucosal resection or gastrectomy considering the patients' age, general condition and the size and the location of the dysplastic lesion.