Pathology of gastric intestinal metaplasia: clinical implications.
Pathology of gastric intestinal metaplasia: clinical implications.
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DOI：
10.1038/ajg.2009.728
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发表时间：
2010-03
影响因子：
9.8
通讯作者：
Wilson, Keith T.
中科院分区：
文献类型：
--
作者：
Correa, Pelayo;Piazuelo, M. Blanca;Wilson, Keith T.
胃粘膜的肠上皮化生（IM）是一种相对常见的癌前病变[1]。在胃活检病理报告中包含IM通常会给胃肠病学家带来关于适当处理的不确定性。尽管IM患者胃癌风险增加，但IM患者胃癌的总体风险与Barrett食管（BE）患者腺癌风险相比极低（2）。虽然胃癌的发病率在某些地区很高，如亚洲和拉丁美洲，但在美国和其他西方国家要低得多，因此很难证明广泛的监测计划是合理的。这篇文章的目的是（i）帮助临床医生确定胃癌风险增加的IM患者亚组，（ii）考虑到缺乏可适用于任何人群的普遍接受的指南，提出一种胃IM管理算法。
Intestinal metaplasia (IM) of the gastric mucosa is a relatively frequent precancerous lesion (1). The inclusion of IM in a gastric biopsy pathology report often creates uncertainty for the gastroenterologist about the appropriate management. Although the risk of gastric cancer is increased in the presence of IM, the overall risk of gastric cancer in a patient with IM is extremely low compared with the risk of adenocarcinoma in a patient with Barrett’s esophagus (BE)(2). Although the incidence of gastric cancer is high in certain regions, such as Asia and Latin America, it is much lower in the United States and other Western countries, making it difficult to justify broad surveillance programs. The aims of this article are (i) to assist the clinician in identifying subgroups of patients with IM at increased risk for gastric cancer and (ii) to propose an algorithm for gastric IM management, considering the lack of universally accepted guidelines that can be applied to any population.
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