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Endoscopy 2004; 36(5): 390-396
DOI: 10.1055/s-2004-814330
Original Article
© Georg Thieme Verlag Stuttgart · New York

Long-Term Follow-Up Study of Gastric Adenoma/Dysplasia

H.  Yamada1 , M.  Ikegami2 , T.  Shimoda3 , N.  Takagi4 , M.  Maruyama4
  • 1Dept. of Internal Medicine, Kawaguchi Municipal Medical Center, Saitama, Japan
  • 2Dept. of Pathology, Jikei University School of Medicine, Tokyo, Japan
  • 3Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan
  • 4Foundation for the Detection of Early Gastric Carcinoma, Tokyo, Japan
Further Information

Publication History

Submitted 28 April 2003

Accepted after Revision 30 November 2003

Publication Date:
21 April 2004 (online)

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Background and Study Aims: The natural course of gastric adenoma/dysplasia, regarded as a precancerous lesion, is still uncertain.
Patients and Methods: From 1976 to 2000, 48 lesions in 43 patients (37 men, six women; mean age 59 years) were diagnosed as having gastric adenoma/dysplasia based on their first biopsies. These lesions were followed for a median of 4.7 years (mean 6 years, range 3-18 years) to evaluate the risk of progression to invasive carcinoma. Retrospectively, histological diagnoses of the biopsy and resected specimens were reclassified according to the Vienna classification of gastrointestinal epithelial neoplasia, and macroscopic changes were evaluated.
Results: The diagnosis at first biopsy of the 48 lesions was low-grade adenoma/dysplasia (LGD; category 3) in 38 cases and high-grade adenoma/dysplasia (HGD; category 4) in 10 cases. Ninety-seven percent of the LGD (category 3) lesions (37 of 38) showed no histological changes during the follow-up period; the remaining lesion progressed to noninvasive carcinoma (category 4). Macroscopically, 84 % (32 of 38) of the LGD lesions (category 3) showed no remarkable changes in size, while 11 % (four of 38) shrank and 5 % (two of 38) grew larger. Nine of the 10 HGD lesions (category 4) remained histologically unchanged, while the other progressed to intramucosal carcinoma (category 5). Macroscopically, four of the 10 HGD lesions (category 4) (40 %) showed no remarkable changes in size, while the remaining six (60 %) grew larger.
Conclusions: LGD lesions (category 3) have a quite low risk of progressing to HGD or noninvasive carcinoma (category 4), and were never observed to progress to invasive carcinoma (category 5). HGD lesions (category 4) occasionally progressed to intramucosal carcinoma (category 5), with no instance of invasion into the submucosa or beyond.

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H. Yamada, M. D.

Dept. of Internal Medicine · Kawaguchi Municipal Medical Center

180 Nishi-araijuku, Kawaguchi-shi · Saitama 333-0833 · Japan

Fax: +81-48-280-1570

Email: hiroy@oak.ocn.ne.jp

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