위 전암성 병변에 대한 내시경적 추적 관찰 = Endoscopic Follow-up Examination of The Precancerous Lesions in Stomach

다국어 초록 (Multilingual Abstract)

Background: The aims of this study were to investigate the endoscopic findings of precancerous lesions of stomach and to see whether or not these lesions could progress to the carcinoma. Method: May 2000 to February 2001, consecutive patients diagnosed as having chronic active gastrits (CAG), intestinal metaplasia (IM), dysplasia, adenoma by endoscopic biopsy were enrolled. A total of 359 patients were included in this study and endoscopically followed-up to Autust 2001. Results; Among all 33 patients (26 dysplasia, 7 dysplasia with adenoma) diagnosed as dysplasia by endoscopic biopsy, there were 6 chronic erosive gastritis (CEG), 6 chronic erosion, 17 adenoma, 4 R/O cancer. On follow-up endoscopic biopsy (17 patients), there were 3 IM, 4 dysplasia, 5 adenoma, 5 carcinoma. Among all 107 patients (53 IM, 38 IM with CAG, 14 IM with CEG, 1 IM with adenoma, 1 IM with dysplasia) diagnosed as IM by endoscopic biopsy, there were 52 CEG, 33 chronic erosion, 6 local lesion, 5 adenoma, 5 R/O cancer, 3 gastric polyp, 3 atrophy with IM> On follow-up endoscopic biopsy (25 patients), there were 2 chronic gastritis, 1 CEG, 3 CAG, 14 IM 3 dysplasia, 2 adenoma, 1 carcinoma. Among all 185 patients (147 CAG, 37 CAG with IM, 1 CAG with adenoma) diagnosed as CAG by endoscopic biopsy, there were 86 CEG, 62 chronic erosion, 4 local lesion, 10 adenoma, 16 R/O cancer, 4 gastric polyp, 2 IM, 1 chronic gastritis. On follow-up endoscopic biopsy (35 patients), there were 8 chronic gastritis, 3 CEG, 14 CAG, 5 IM, 2 dysplasia, 1 adenoma, 2 arcinoma. Among All 34 patiets (22 adenoma, 8 adenoma with low grade dysplasia, 2 adenoma with moderate grade dysplasia, 2 adenoma with high grade dysplasia) diagnosed as gastric adenoma by endoscopic biospy, there were 1 local lesion, 24 adenoma, 2 R/O cancer, 7 gastric polyp. On follow-up endoscopic biopsy (17 patients), there were 2 CEG, 2 low grade dysplasia, 1 high grade dysplasia, 4 adenoma 1 adenoma with dysplasia, 4 adenoma with low grade dysplasia, 2 adenoma with high grade dysplasia, I cancerous change. Conclusions: Althought it was short period, there were some of cancerous change in precancerous lesions at follow-up endoscopy. This study suggests that screening for precancerous lesions, is one method of improving the prognosis of gastric carcinoma and when the precancerous lesions are diagnosed on endoscopy, serial endoscopic follow-up should be done to find early gastric cancer.