scholarly journals LOW-GRADE DYSPLASIA, ENDOSCOPIC PREDICTORS, MANAGEMENT TACTICS

2020 ◽  
pp. 10-14
Author(s):  
A. A. Arkhipova ◽  
V. V. Anischenko
Keyword(s):  
Precancerous Lesions ◽  
Low Grade ◽  
Cytological Examination ◽  
Spontaneous Bleeding ◽  
Mild Dysplasia ◽  
Brush Biopsy ◽  
White Light Endoscopy ◽  
Low Grade Dysplasia ◽  
H Pylori ◽  
Almost All

Almost all East Asian strains and 60% of Western H. pylori strains are of cagA +. The infected patients develop a more pronounced inflammation with ulceration of stomach, and also are under a higher risk of development of cancer.Objective: to improve the informative value of dysplasia diagnosis by combining white light endoscopy with chromoscopy, supplemented by target brush biopsy with cytological examination.Methods and materials: for the period from 2016 to 2018, the study included 41 patients undergoing examination and treatment of chronic gastritis. The analyzed cases included 16 (39%) men and 25 (61%) women. The age of the patients ranged from 19 to 86 years. All patients underwent esophagogastroduodenoscopy, chromoendoscopy with 0.5% methylene blue, brush biopsy (scraping with a nylon brush). At least two brush preparations were obtained: body of the stomach, antrum, scraping was also made on the surface of erosions and areas of atypical structure of the epithelium. Brush preparations were sent for cytological examination. Results: esophagogastroduodenoscopy revealed erosions in 37 (90.2%) patients, in 6 cases (14.6%) among them spontaneous bleeding was determined. In 23 (56%) patients visual signs of atrophic gastritis were noted. Cylindrical epithelium of the intestinal type was revealed in 25 patients (61%) using methylene blue.The cytological examination of the brush preparation showed proliferation of the integumentary epithelium with signs of mild dysplasia in all cases, intestinal metaplasia was revealed in 27 patients (65.8%), H. Pylori was confirmed in 38 patients (92.6%).Conclusion: chromoscopy and brush biopsy are simple and affordable methods, and their integration into routine endoscopy increases the informative value of the study, namely, allows detection of precancerous lesions of mucosa.

scholarly journals LECTIN BINDING PATTERNS IN NORMAL, DYSPLASTIC AND HELICOBACTER PYLORI INFECTED GASTRIC MUCOSA

2017 ◽  
Vol 39 (2) ◽  
pp. 138-140 ◽  
Author(s):  
S Vernygorodskyi ◽  
V Shkolnikov ◽  
D Suhan
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Precancerous Lesions ◽  
Lectin Binding ◽  
Helix Pomatia ◽  
Low Grade ◽  
Con A ◽  
Protocol Biopsy ◽  
Low Grade Dysplasia ◽  
H Pylori

Aim: To analyze the glycoprotein binding sites of the gastric mucosa and its secreted mucus using lectin histochemistry in patients with chronic non-atrophic gastritis (CNAG) associated or not-associated with Helicobacter pylori infection with or without dysplasia. Materials and Methods: In order to identify the areas with glycoconjugates expression in gastric mucosa, 6 lectins (Canavalia ensiformis agglutinin — Con A, Sambucus nigra agglutinin — SNA, wheat germ agglutinin — WGA, soybean agglutinin — SBA, Helix pomatia agglutinin — HPA, peanut agglutinin — PNA) were used. Carbohydrate determinants were visualized according to the lectin-peroxidase-diaminobenzidine staining protocol. Biopsy material was obtained and processed by conventional histological methods. The samples from 84 patients (54 with CNAG) with low (n = 34) and high grade (n = 20) dysplasia, 38 patients were H. pylori-infected and 26 patients — H. pylori-noninfected) were used. The comparison group included 30 persons with CNAG without dysplasia (16 patients H. pylori-infected and 14 — noninfected). Results: In comparison to normal gastric mucosa, a low affinity of Con A was shown in 80% of patients with non-infected CNAG and 90% of H. pylori associated CNAG. In 70% of H. pylori-infected patients with CNAG and low grade dysplasia there was an increase of SNA expression compared with noninfected patients (p < 0.05). Regarding SBA labeling no differences were detected in the studied groups (p < 0.05). In H. pylori infected patients with CNAG and low grade dysplasia, WGA, HPA and PNA showed a strong reactivity with the gastric mucosa cells in 80; 75%, and 60% of patients, respectively. Conclusion: We suggest that a set of lectins in reaction with gastric epithelial and glandular cells can be used as a tool to obtain information about the dysplastic changes of the gastric mucosa and may offer new insight into gastric carcinogenesis and precancerous lesions treatment.

scholarly journals Chronic gastritis and precancerous diseases of the stomach: Is there a chance of a correct diagnosis?

2021 ◽  
Vol 13 (1) ◽  
pp. 85-102
Author(s):  
Aleksandr V. Tryapitsyn ◽  
Vladimir A. Malkov ◽  
Emil M. Gasanov ◽  
Ilya Belyakov
Keyword(s):  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Correct Diagnosis ◽  
Intraepithelial Neoplasia ◽  
Autoimmune Gastritis ◽  
Low Grade ◽  
Adequate Treatment ◽  
H Pylori ◽  
Almost All

AIM: The purpose of the study is to investigate the occurrence of the main forms of chronic gastritis, metaplastic and dysplastic changes in the gastric mucosa, the degree of their severity, and to assess their potential risk for the development of gastric cancer. MATERIALS AND METHODS: The study involved 2982 patients who underwent esophagogastroduodenoscopy with a standard biopsy of the gastric mucosa for morphological assessment and bacterioscopy. If autoimmune gastritis was suspected, an additional serological diagnosis was performed. When detecting intestinal metaplasia of the gastric mucosa as well as neoplastic changes according to the histological report, the description of this report was analyzed in order to identify possible equivalents in the macroscopic description of the mucous membrane. RESULTS: Out of 2982 histological studies of gastric mucosa biopsies, 1273 cases (42.7%) were found to contain H. pylori contamination. In 726 cases (24.3%), intestinal metaplasia. 66 biopsies (2.21%) showed the presence of low-grade intraepithelial neoplasia of the mucosa, 2 biopsies showed indeterminate neoplasia and 4 biopsies showed high-grade neoplasia. In 3 out of the total number of the samples, intravascular gastric adenocarcinoma was detected. In 168 cases (5.6%), gastritis was detected with predominant inflammation of the fundal region characteristic of autoimmune gastritis. In 286 biopsies (10.6%), inflammatory and/or atrophic changes and/or metaplastic changes were preserved, which, as a rule, did not have high activity and pronounced inflammation. In the remaining 1279 cases (42.9%), there was no significant inflammation or atrophic changes. The analysis of endoscopic findings showed that the detectability of intestinal metaplasia of the gastric mucosa without a biopsy study was 13.3%. DISCUSSION OF THE RESULTS: According to the results of the conducted research and analysis, it can be stated that at present, the correct diagnosis of chronic gastritis with the establishment of the etiological factor, prognosis and risks of stomach cancer development is practically not feasible within the modern health care system. This not only deprives a doctor of the opportunity to make a correct diagnosis and prescribe adequate treatment to a patient, but also makes almost all cascades of carcinogenesis, including early cancer, invisible.

scholarly journals Onset and Progression of Precancerous Lesions on Gastric Mucosa of Patients Treated for Gastric Lymphoma

2020 ◽  
Vol 29 (1) ◽  
pp. 27-31
Author(s):  
Angelo Zullo ◽  
Angela Rago ◽  
Stefano Felici ◽  
Stefano Licci ◽  
Lerenzo Ridola ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Mucosa ◽  
Malt Lymphoma ◽  
Precancerous Lesions ◽  
Gastric Lymphoma ◽  
B Cell Lymphoma ◽  
Low Grade ◽  
Primary Gastric Lymphoma ◽  
Low Grade Dysplasia

Background and Aims: Patients with primary gastric lymphoma are at an increased risk of developing gastric cancer. Data on gastric precancerous lesions development in these patients are scanty. We assessed gastric precancerous lesions in a cohort of patients with primary lymphoma. Methods: Data of patients with primary gastric lymphoma [mucosa-associated lymphoid tissue (MALT)- lymphoma or diffuse large B-cell lymphoma (DLBCL)] were analysed. Multiple (>10) biopsies were performed on gastric mucosa at each endoscopic control, beyond macroscopic lesions. Presence and distribution of intestinal metaplasia (IM) at baseline, the onset at follow-up, and progression through the stomach or transformation in the incomplete IM type were assessed. The onset of neoplastic lesions was recorded. Results: Data of 50 patients (mean age of 63.6 ± 10.7 years; M/F: 25/25), including 40 with MALT-lymphoma and 10 with DLBCL, with median follow-up of 30.5 months (range: 9-108) and a median of 6 endoscopic controls (range: 3-14) were evaluated. At entry, IM was present in 12 (24%), and it developed in other 22 (57.9%) patients at a median follow-up of 6 (range: 3-40) months. Overall, progression of IM was observed in 7 (21.2%) cases, including extension in the stomach (n=5) or transformation into the incomplete type (n=2). Low-grade dysplasia was detected in 4, and indefinite dysplasia in other 7 patients. In one patient, low-grade dysplasia had progressed to high-grade and gastric adenocarcinoma of the fundus. Conclusions: Our data found a frequent onset and rapid progression of precancerous lesions on gastric mucosa of lymphoma patients. This observation could explain the increased incidence of metachronous gastric cancer in these patients.

scholarly journals Spectrum of Colonic Polyps in a South Indian Urban Cohort

2017 ◽  
Vol 08 (03) ◽  
pp. 119-122
Author(s):  
Mayank Jain ◽  
Mukul Vij ◽  
M. Srinivas ◽  
Tom Michael ◽  
Jayanthi Venkataraman
Keyword(s):  
Colonic Polyps ◽  
Common Type ◽  
Left Colon ◽  
Adenomatous Polyps ◽  
Low Grade ◽  
Hyperplastic Polyps ◽  
Right Colon ◽  
South Indian ◽  
Low Grade Dysplasia ◽  
Almost All

ABSTRACT Background: The histological nature of polyps by site prevalence and size is unclear. Aim: To determine the prevalence of polyps in patients undergoing routine lower gastrointestinal (LGI) endoscopy and identify the histological types and their characteristics by age, location and size. Materials and Methods: For this retrospective study, patients undergoing ileocolonoscopy or sigmoidoscopy between 2014 and 2016 were included. Data on age, gender, test indication, site and size of polyps and histology type were collected. Results: Two hundred and ninety (12.7%) of 2303 patients who underwent LGI endoscopy had colonic polyps (n= 317; single in 272 patients). The median age was 61.1 years (range 5-99 years) and 223 (76.4%) were men. Polyps were rare <40 years age (7.3%). By site, the polyp frequency in right colon was 6.9%, 3.9% in left colon and 4.6% in the rectum. Two thirds of polyps (64%) were <1cm size. The 3 common polyp types were adenomatous (48.9%), hyperplastic (23.7%), and inflammatory (22.4%). Adenomatous polyps were common above 60 years (p <0.0002), located often in right (35.5%) or left colon (42.6%), large in size (54.2%) and showed low grade dysplasia (89.7%). Hyperplastic polyps were most common in the middle aged and in the rectum (p <0.00001). Inflammatory polyps were the most common type below 40 years age. Almost all hyperplastic and inflammatory polyps were <1cm size (93.3% and 87.3%). Conclusions: Adenomatous polyps were the commonest type; especially >60 years age. High grade dysplasia and carcinoma were rare (10.3%). While two-thirds of polyps <1cm size were inflammatory or hyperplastic, 86% of large polyps were adenomatous.

scholarly journals ENDOSCOPIC DIAGNOSIS OF DYSPLASIA IN PATIENTS WITH LONGSTANDING ULCERATIVE COLITIS

2020 ◽  
Vol 19 (1) ◽  
pp. 37-50
Author(s):  
O. V. Arkhipova ◽  
S. N. Skridlevskiy ◽  
V. V. Veselov ◽  
O. A. Majnovskaya
Keyword(s):  
Ulcerative Colitis ◽  
Indigo Carmine ◽  
Endoscopic Diagnosis ◽  
Low Grade ◽  
Targeted Biopsy ◽  
High Definition ◽  
White Light Endoscopy ◽  
Endoscopic Remission ◽  
Low Grade Dysplasia ◽  
Long Course

AIM: to evaluate high-definition colonoscopy (HD-WLE) using chromoendoscopy for dysplasia in the longstanding ulcerative colitis (UC).PATIENTS AND METHODS: a cohort prospective study included 140 patients (aged 29-79 years old) with a long course of UC (6-44 years) in time of endoscopic remission with good quality of bowel cleansing. A white-light endoscopy was performed using high-definition colonoscopies (HD-WLE). Chromoendoscopy (0.4% solution of indigo carmine), targeted biopsy, and histological analysis were performed.RESULTS: HD-WLE revealed 34 lesions with endoscopic signs of dysplasia in 27 (19.3%) patients: in 20 patients – 1 (74.1%) lesion, in 7 patients 2 (25.9%). In 22 patients (64.7%) lesions were more than 1 cm.Chromoendoscopy confirmed the signs of dysplasia in 100.0% of cases (88.2% – low grade dysplasia).Histologically, low-grade dysplasia was detected in 58.8% of cases, undetected dysplasia – in 20.6%, sporadic adenomas – in 20.6%.The effectiveness of endoscopic diagnosis for detecting dysplasia was 74%. A comparative analysis of the endoscopic signs of dysplasia and sporadic adenomas showed the absence of significant differences.CONCLUSION: the additional chromoendoscopy during HD-WLE colonoscopy with targeted biopsy does not lead to increase of colorectal epithelial dysplasia detection in UC.The experience of endoscopist should be considered when making decision which type of endoscopy for dysplasia detection in UC is needed.

Prevalence, Characteristics and Endoscopic Management of Gastric Premalignant Lesions in France

2019 ◽  
Vol 38 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Nicolas Chapelle ◽  
Matthieu Péron ◽  
Jean-François Mosnier ◽  
Lucille Quénéhervé ◽  
Emmanuel Coron ◽  
...  
Keyword(s):  
Precancerous Lesions ◽  
Real Life ◽  
Premalignant Lesions ◽  
Endoscopic Management ◽  
Low Grade ◽  
Upper Endoscopy ◽  
Gastric Biopsies ◽  
H Pylori ◽  
Histological Results

Introduction: Surveillance of gastric precancerous lesions (GPL) is recommended, but the data on their clinical and endoscopic management in a “real-life” practice are limited. Our aim was to study the modalities of endoscopic management of patients with GPL in France. Design: All the patients diagnosed with GPL in our center between 2000 and 2015 were grouped and analyzed according to the most severe GPL found, in the following order: atrophic gastritis only (AG), intestinal metaplasia (IM), low grade dysplasia (LGD), high grade dysplasia (HGD). Results: Out of 16,764 patients having undergone upper endoscopy with gastric biopsies, 507 were identified with GPL (detection rate 3.2%). Overall, Helicobacter pylori infection was found in 41% of patients. IM was by far the most frequently found lesion (79%), followed by LGD (17%), HGD (2%), and AG only (2%). H. pylori infection rate was decreasing, while the age of the patients was increasing, together with the increasing severity of GPL (p = 0.005). Only 28% of the patients had at least one follow-up endoscopy. No correlation was found between the endoscopist’s appreciation of the mucosa and histological results. Conclusion: In France, GPL can be expected in about 3% of patients undergoing upper endoscopy with gastric biopsies for any reason. The correlation between the endoscopic evaluation and histology is poor. Spreading of published guidelines should improve the management of patients with GPL in the future.

572 Clinical Implications of Low-Grade Dysplasia Detected During Surveillance of IBD Patients: A Closer Look at Chromoendoscopy and High-Definition White Light Endoscopy

2016 ◽  
Vol 83 (5) ◽  
pp. AB153
Author(s):  
Joren Ten Hove ◽  
Erik Mooiweer ◽  
Andrea Van Der Meulen ◽  
Evelien Dekker ◽  
Cyriel Ponsioen ◽  
...  
Keyword(s):  
White Light ◽  
Clinical Implications ◽  
Low Grade ◽  
High Definition ◽  
White Light Endoscopy ◽  
Low Grade Dysplasia
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