The Natural History and Treatment Strategy of Gastric Adenoma as a Pre-cancerous Lesion
Korean J Helicobacter Up Gastrointest Res 2018;18(2):103-109
Published online June 10, 2018
© 2018 Korean College of Helicobacter and Upper Gastrointestinal Research.

Soo In Choi, Jun Chul Park

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Jun Chul Park
Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-5201, Fax: +82-2-365-2125, E-mail: JUNCHUL75@yuhs.ac
ORCID: https://orcid.org/0000-0001-8018-0010
Received February 8, 2018; Revised April 11, 2018; Accepted April 11, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The concept and pathological diagnostic criteria of gastric adenoma (dysplasia) differ between Western countries and Japan, and discrepancies between histopathological examinations before and after endoscopic resection may occur. Therefore, the natural history of adenoma should be interpreted and the treatment strategy of adenoma established. It is recommended that endoscopic resection be performed for high-grade dysplasia due to the potential higher risk of progression to carcinoma. For low-grade dysplasia, the risk of malignant transformation is relatively low. However, resection is considered the first approach for the purpose of diagnosis and treatment. If resection is not feasible, the alternative may be to use argon plasma coagulation for selected lesions that are less likely to be malignant. When Helicobacter pylori infection is detected, eradication therapy is recommended to reduce the risk of metachronous lesions. Post-resection follow-up should be performed within 1 year to detect synchronous lesions and then follow-up endoscopy at 1 or 2-year intervals may be considered for metachronous lesions.
Keywords : Adenoma; Dysplasia; Natural history; Stomach; Treatment


September 2018, 18 (3)
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