EARLY AND ADVANCED GASTRIC-CANCER IN THE FOLLOW-UP OF MODERATE AND SEVERE GASTRIC DYSPLASIA PATIENTS - A PROSPECTIVE-STUDY
EARLY AND ADVANCED GASTRIC-CANCER IN THE FOLLOW-UP OF MODERATE AND SEVERE GASTRIC DYSPLASIA PATIENTS - A PROSPECTIVE-STUDY
复制标题
DOI：
10.1055/s-2007-1010310
复制
发表时间：
1993-05-01
期刊：
影响因子：
9.3
通讯作者：
BAFFA, R
中科院分区：
文献类型：
--
作者：
FARINATI, F;RUGGE, M;BAFFA, R
胃上皮发育不良（GED）作为胃癌生物学和形态学前兆的作用已被广泛研究，但很少有研究前瞻性评估其演变为胃癌的风险。 1985年，对高度（中度或重度）GED患者进行了一项前瞻性多中心随访研究。该研究涉及 49 名患者，目前平均随访 18.8 个月（范围：1-70），平均进行 4 次内窥镜检查（范围：2-10）。当随后 2 次对照内窥镜检查和 1 年期间 GED 呈阴性，或检测到肿瘤时，放弃随访。 16 例（33%）被诊断出胃癌。 10 名患者（62%）在早期阶段就发现了癌症。 11 例（59%）在随访 1 年内确诊，5 例分别在 13、18、21、24 和 39 个月后确诊。 36% 的中度 GED 病例和 80% 的严重 GED 病例与癌症相关。 27% 的中度病例和 10% 的重度病例在随访时不再检测到发育异常变化。这两种病变与胃癌相关或演变成胃癌的相对风险分别为 26 和 132。总之，重度（中度或重度）GED 经常与胃癌相关或演变成胃癌。对患者的随访大大提高了早期诊断胃癌的机会，因此必须采取这种方法。
The role of gastric epithelial dysplasia (GED) as a biological and morphological precursor of gastric cancer has been widely investigated, but few studies have prospectively evaluated the risk of its evolution into gastric cancer. In 1985, a prospective multicenter follow-up study was undertaken on patients with high-grade (moderate or severe) GED. The study involved 49 patients, with a follow-up currently averaging 18.8 months (range: 1-70) and a mean number of 4 endoscopies (range: 2-10). Follow-up was abandoned when 2 subsequent control endoscopies and a 1-year period were negative for GED, or when neoplasia was detected. Gastric cancer was diagnosed in 16 cases (33 %). The cancer was detected at an early stage in 10 patients (62 %). Eleven cases (59 %) were diagnosed within 1 year of follow-up and 5 cases after 13, 18, 21, 24 and 39 months, respectively. Cancer was associated with 36 % of moderate GED cases and with 80 % of severe cases. Dysplastic changes were no longer detectable at follow-up in 27 % of the moderate cases and in 10 % of the severe cases. The relative risks for the two lesions being associated with or evolving into gastric cancer were 26 and 132, respectively. In conclusion, high-grade (moderate or severe) GED is frequently associated with or evolves into gastric cancer. The follow-up of patients considerably enhances the chances of diagnosing gastric cancer in its early stages, thus making such an approach mandatory.