scholarly journals Morphological characteristics of dysplasia in the mucous membrane adjacent to the tumor in intestinal type gastric cancer

2021 ◽  
Vol 10 (3) ◽  
pp. 47-54
Author(s):  
L.V. Volkova ◽  
Keyword(s):  
Gastric Mucosa ◽  
Mucous Membrane ◽  
High Grade Dysplasia ◽  
Intestinal Type ◽  
Field Cancerization ◽  
Low Grade ◽  
Frequency Of Occurrence ◽  
High Grade ◽  
Resection Line ◽  
Low Grade Dysplasia

Introduction. Despite a significant number of publications and a concept known as Correa’s cascade, dysplas-tic processes and the mechanisms of gastric carcinogenesis, are still far from being completely understood. Dysplasia and the processes in the mucous membrane adjacent to the tumor node, their significance, and their role in the field cancerization have also been studied insufficiently. The aim of this work was to analyze the frequency of occurrence and some characteristics of high- and low-grade dysplasia in the gastric mucosa at variable distances from the tumor node. Materials and methods. We carried out a prospective histological study of surgical specimens from 49 patients with intestinal type gastric adenocarcinoma. We studied tissues from the tumor node and adjacent gastric mucosa at various distances from the tumor and assessed the frequency of occurrence and some characteristics of low- and high-grade dysplasia. Results. In the mucous membrane adjacent to the intestinal type adenocarcinoma, 73.5% of cases demon-strated low- and high-grade dysplasia. In all cases, background and precancerous processes were found in areas adjacent to the tumor node with low- and high-grade dysplasia. Conclusion. The incidence of low- and high-grade dysplasia detected in the mucous membrane adjacent to intestinal type gastric adenocarcinoma significantly decreases as the distance from the tumor node in-creases. Dysplastic changes are associated with epithelial hyperplasia, intestinal metaplasia, and inflamma-tory and atrophic changes. The results obtained support field cancerization and highlight the need to study morphological, molecular, and genetic alterations in the gastric mucosa adjacent to the tumor more deeply. The dysplastic changes present at the resection line area indicate that this fact must be considered when determining the resection line. Keywords: gastric cancer, low-grade dysplasia, high-grade dysplasia, epithelial dysplasia, intestinal meta-plasia, inflammatory infiltration, atrophy

Endoscopic Surveillance Practice for Barrett's Oesophagus in Scotland and Early Experience in Implementing Local Guidelines

2003 ◽  
Vol 48 (2) ◽  
pp. 43-45 ◽  
Author(s):  
E F Shen ◽  
S Gladstone ◽  
G Milne ◽  
S Paterson-Brown ◽  
I D Penman
Keyword(s):  
Early Experience ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Wide Variability ◽  
Low Grade Dysplasia ◽  
Surveillance Practice ◽  
Four Quadrant ◽  
The Impact

Management of columnar lined oesophagus (CLO; Barrett s oesophagus) is controversial. We prospectively audited surveillance practices in Scotland and prospectively assessed the impact of introducing local guidelines for Barrett s surveillance in Edinburgh. Most respondents were gastroenterologists. The majority take random, not four quadrant, biopsies from the CLO. In Edinburgh during 2000, 80 patients underwent surveillance. The guideline protocol was not followed in 30 (37.5%) patients. Follow up of patients without dysplasia generally conformed to the guidelines. Follow up of patients with low grade dysplasia was highly variable while management of those with high grade dysplasia followed the guidelines. Overall we found a wide variability in the management and surveillance of CLO. Early experience suggests that implementation of guidelines is helpful but there is still variation in practice.

scholarly journals Persistent confirmed low-grade dysplasia in Barrett's esophagus is a risk factor for progression to high-grade dysplasia and adenocarcinoma in a US Veterans cohort

2019 ◽  
Author(s):  
K Y Song ◽  
A J Henn ◽  
A A Gravely ◽  
H Mesa ◽  
S Sultan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Independent Risk Factor ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Increased Risk ◽  
Low Grade Dysplasia

SUMMARY Patients with Barrett's esophagus (BE) and low-grade dysplasia (LGD) are at increased risk of esophageal adenocarcinoma (EAC), although many regress to nondysplastic BE. This has significant clinical importance for patients being considered for endoscopic eradication therapy. Our aim is to determine the risk for progression in patients with confirmed persistent LGD. We performed a single-center retrospective cohort study of patients with BE and confirmed LGD between 2006 and 2016. Confirmed LGD was defined as LGD diagnosed by consensus conference with an expert GI pathologist or review by an expert GI pathologist and persistence as LGD present on subsequent endoscopic biopsy. The primary outcome was the incidence rate of HGD (high-grade dysplasia)/EAC. Secondary outcomes included risk factors for dysplastic progression. Risk factors for progression were assessed using univariate and multivariate analysis with logistic regression. Of 69 patients (mean age 65.2 years) with confirmed LGD were included. In total, 16 of 69 patients (23.2%) with LGD developed HGD/EAC during a median follow-up of 3.74 years (IQR, 1.24–5.45). For persistent confirmed LGD, the rate was 6.44 (95% confidence interval (CI), 2.61–13.40) compared to 2.61 cases per 100 patient-years (95% CI, 0.83–6.30) for nonpersistent LGD. Persistent LGD was found in only 29% of patients. Persistent LGD was an independent risk factor for the development of HGD/EAC (OR 4.18; [95% CI, 1.03–17.1]). Persistent confirmed LGD, present in only 1/3 of patients, was an independent risk factor for the development of HGD/EAC. Persistence LGD may be useful in decision making regarding the management of BE.

Increased risk of high-grade dysplasia and colorectal cancer in inflammatory bowel disease patients with recurrent low-grade dysplasia

2020 ◽  
Vol 91 (6) ◽  
pp. 1334-1342.e1 ◽  
Author(s):  
Michiel E. de Jong ◽  
Heleen Kanne ◽  
Loes H.C. Nissen ◽  
Joost P.H. Drenth ◽  
Lauranne A.A. P. Derikx ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
Low Grade Dysplasia

Tu1144 Dysplastic Burden in Barrett's Esophagus With Low-Grade Dysplasia Is Associated With Progression to High-grade Dysplasia or Adenocarcinoma

2016 ◽  
Vol 83 (5) ◽  
pp. AB552
Author(s):  
Allon Kahn ◽  
Jonathan K. Callaway ◽  
Mohanad Al-Qaisi ◽  
David E. Fleischer ◽  
George E. Burdick ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Low Grade Dysplasia

scholarly journals Update on endoscopic treatment of Barrett’s oesophagus and Barrett’s oesophagus–related neoplasia

2020 ◽  
Vol 13 ◽  
pp. 263177452093524
Author(s):  
Oliver Pech ◽  
Saleh A. Alqahtani
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Resection ◽  
High Grade Dysplasia ◽  
Barrett’S Oesophagus ◽  
Low Grade ◽  
High Grade ◽  
Barrett's Oesophagus ◽  
Barrett’S Cancer ◽  
Visible Lesion ◽  
Low Grade Dysplasia

Endoscopic therapy of early Barrett’s oesophagus–related neoplasia is the treatment of choice for low-grade-dysplasia, high-grade dysplasia and mucosal Barrett’s cancer. Low-grade-dysplasia without any visible lesion should be ablated, preferably with radiofrequency ablation. In cases with the presence of a visible lesion, high-grade dysplasia and early Barrett’s adenocarcinoma, endoscopic resection techniques like multiband ligation endoscopic resection or endoscopic submucosal dissection should be applied. After complete resection of all visible neoplastic lesions, ablation of the remaining Barrett’s oesophagus should be performed to prevent recurrence. Ablation techniques available are radiofrequency ablation, argon plasma coagulation and cryoablation.

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