Gastric precancerous lesions

By | April 6, 2012

Gastric precancerous lesions is a pathological concept, refers to easy into gastric epithelial cancer pathology, but in itself does not have the malignant change. Recognized at this stage is gastric epithelial dysplasia (also known as atypical hyperplasia), the main pathological changes of cell proliferation and excessive loss of normal differentiation, the structure and function in the loss of part of the original organization similarity.
1. Stomach and epithelial dysplasia (gastric epithelial dysplasia, GED) are usually divided into the gastric epithelial dysplasia occurred in several histological types:
(1) dysplasia adenoma (adenomatous dysplasia): This type is characterized by dysplasia in the stomach flat elevation straw membrane lesions formed on the surface, sometimes hemispherical. Uplift lesion diameter not more than 2.0cm, if more than 2.0cm, should pay attention to whether the cancer problem. Dysplasia adenoma on histopathology was obvious limitations spotty, irregular glandular proliferation by the large number of form, tubular, large or small, but generally much larger, closely arranged, shaped significantly by the degree can also be found duct "back to back" phenomenon, lesions and around the boundaries between gastric obvious, but the phenomenon of the surrounding tissue without compression.
Dysplasia occurred early, found only in a small number of abnormal glandular stomach Weng local film surface increased with the degree of lesion, lesion only gradually expanded, and extended deep to the mucosa and mucosa of the whole layer. Adenoma dysplasia is a neoplastic mass, usually a small can reverse, can not differentiate to mature or disappear. Reported in the literature, this type of abnormal gastric cancer after cancer of Health as well differentiated adenocarcinoma.
(2) recess-type dysplasia (cryptal dysplasia): This type profiled by: Endoscopic majority is mainly present in the gastric antrum granular Long-prone lesions, pathological characteristics are the primary site of intestinal metaplasia in the gland Department of pipe recess, the deep mucosa. But with different adenoma dysplasia, crypt type profiled students mainly associated with atrophy and intestinal metaplasia in the mucosa, intestinal metaplasia is less reserve of abnormal cell proliferation and differentiation, under certain conditions, abnormal epithelial cells reversal of differentiation to mature.
(3) other less common types of dysplasia: Regenerative dysplasia (regenerative dysplasia), ball-type dysplasia (globoid dysplasi-a), shaped gland cyst or cystic dysplasia (dysplastic cyst, cystic dys-plasia). Clinical often in the atypical hyperplasia is divided into mild, moderate and severe grade 3, general and severe dysplasia prone to cancer, dysplasia is cancer inevitable process of a stage, this process is a continuous process of band-like that the proliferation of normal gastric mucosa dysplasia carcinoma in situ, invasive carcinoma, the process to complete the fight is not yet the time required to completely clear or accurate. Cancer rates (mostly adenoma dysplasia) is 5% -10%.
Gastric epithelial dysplasia and gastric cancer close relationship between the facts from the following description: In gastric cancer specimens found in a retrospective analysis, 40% _100% of early gastric cancer associated with moderate and severe dysplasia, the progress of the foci of the stomach next to the 5% _80% have different degrees of dysplasia. From a prospective study found that dysplasia, especially in moderate and severe dysplasia (2 Classification senior dysplasia), Sec time after the development of cancer can be determined.
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