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  • Title: [Gastric dysplasia: its incidence in precancerous conditions, advanced cancer and early cancer].
    Author: Hojman D, Cenoz MC, Even L, Puzzo MA.
    Journal: Acta Gastroenterol Latinoam; 1988; 18(4):231-48. PubMed ID: 3255219.
    Abstract:
    Dysplasia cancer sequence has not been determined in gastric cancer yet. Dysplastic changes are not frequent. Gastric cancer generally develops in areas of chronic atrophic gastritis. This chronic atrophic gastritis (CAG) is often associated with intestinal metaplasia (IM). IM has been classified in three types, according to morphologic patterns, differentiation and mucins production. We reviewed 55 gastrectomy specimens and 278 endoscopic biopsies. In order to determine an histological high-risk group, we chose cases with preneoplastic conditions (60 CAG, 10 biopsies of gastric remnants, 3 flat adenomas and 55 gastrectomies by cancer or ulcer). We also included 12 hyperplastic polyps because they may contain foci of intestinal metaplasia. Mucin techniques (PAS-ALCIAN BLUE Ph 2.5 and HID-A.B) were used in all cases that showed extensive intestinal metaplasia. In addition, we used immunohistochemistry techniques to detect CEA. Dysplasia was found only in flat adenomas (3 cases), early gastric cancer (1 case) and advanced cancer (3 cases). We considered a preneoplastic lesion only to moderate or severe dysplasia. Hyperplastic regenerative pathology is considered a reversible condition. Therefore, it should be differentiated from dysplasia. We found that IM type III (sulfomucin predominance) is the most related to carcinoma, particularly to the intestinal type. CEA antigen is poorly specific in detecting high-risk lesions because it was seen in regenerative pathology and in gastric cancer too. Relationship of dysplasia and carcinoma, and/or neoplastic polyps was similar to other series. Concerning to follow-up items, we agree with the concepts proposed by the Japanese Research Society for Gastric Cancer.
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