Korean J Intern Med.  2016 Mar;31(2):201-209. 10.3904/kjim.2016.021.

Diagnosis and management of gastric dysplasia

• Sung JK

• KMID: 2373795
• DOI: http://doi.org/10.3904/kjim.2016.021

Abstract

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.

Keyword

Intraepithelial neoplasia; Dysplasia; Adenoma; Stomach

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Biopsy
Carcinoma in Situ/classification/microbiology/*pathology/*surgery
Disease Progression
*Gastrectomy/adverse effects/methods
Gastric Mucosa/microbiology/*pathology/*surgery
Gastroscopy
Helicobacter Infections/drug therapy/microbiology
Helicobacter pylori/drug effects
Humans
Neoplasm Grading
Precancerous Conditions/classification/microbiology/*pathology/*surgery
Predictive Value of Tests
Risk Factors
Stomach Neoplasms/classification/microbiology/*pathology/*surgery
Treatment Outcome
Anti-Bacterial Agents