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Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma

BACKGROUND: In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases. METHODS: Among 146 consecutive patients who...

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Autores principales: Na, Hee Kyong, Cho, Charles J., Bae, Suh Eun, Lee, Jeong Hoon, Park, Young Soo, Ahn, Ji Yong, Kim, Do Hoon, Choi, Kee Don, Song, Ho June, Lee, Gin Hyug, Jang, Se Jin, Jung, Hwoon-Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225017/
https://www.ncbi.nlm.nih.gov/pubmed/28072871
http://dx.doi.org/10.1371/journal.pone.0169456
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author Na, Hee Kyong
Cho, Charles J.
Bae, Suh Eun
Lee, Jeong Hoon
Park, Young Soo
Ahn, Ji Yong
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jang, Se Jin
Jung, Hwoon-Yong
author_facet Na, Hee Kyong
Cho, Charles J.
Bae, Suh Eun
Lee, Jeong Hoon
Park, Young Soo
Ahn, Ji Yong
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jang, Se Jin
Jung, Hwoon-Yong
author_sort Na, Hee Kyong
collection PubMed
description BACKGROUND: In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases. METHODS: Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems. RESULTS: Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III–IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively). CONCLUSIONS: Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC.
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spelling pubmed-52250172017-01-31 Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma Na, Hee Kyong Cho, Charles J. Bae, Suh Eun Lee, Jeong Hoon Park, Young Soo Ahn, Ji Yong Kim, Do Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jang, Se Jin Jung, Hwoon-Yong PLoS One Research Article BACKGROUND: In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases. METHODS: Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems. RESULTS: Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III–IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively). CONCLUSIONS: Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC. Public Library of Science 2017-01-10 /pmc/articles/PMC5225017/ /pubmed/28072871 http://dx.doi.org/10.1371/journal.pone.0169456 Text en © 2017 Na et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Na, Hee Kyong
Cho, Charles J.
Bae, Suh Eun
Lee, Jeong Hoon
Park, Young Soo
Ahn, Ji Yong
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jang, Se Jin
Jung, Hwoon-Yong
Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title_full Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title_fullStr Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title_full_unstemmed Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title_short Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma
title_sort atrophic and metaplastic progression in the background mucosa of patients with gastric adenoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225017/
https://www.ncbi.nlm.nih.gov/pubmed/28072871
http://dx.doi.org/10.1371/journal.pone.0169456
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