| Clinical Parameters Including Serum Pepsinogen Level and Management Strategy in Patients with Gastric Low-Grade Dysplasia |
|
Jun Hyung Cho, Young Woon Chang, Young Hwangbo, Jaejun Shim, Jae Young Jang, Hyo Jong Kim, Byung Ho Kim |
|
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea. cywgi@chollian.net |
| 위의 저도 이형성 선종 환자에서 혈청 Pepsinogen을 포함한 임상 지표와 치료 전략 |
|
조준형, 장영운, 황보영, 심재준, 장재영, 김효종, 김병호 |
|
경희대학교 의과대학 내과학교실 |
|
|
| Abstract |
BACKGROUND/AIMS
There are no proper guidelines for the management of gastric low-grade dysplasia (LGD). We evaluated clinical parameters, histological results and follow-up endoscopies to find a management strategy of LGD. MATERIALS AND METHODS: A total of 590 patients with LGD, high-grade dysplasia (HGD), functional dyspepsia (FD), early or advanced gastric cancer (early gastric cancer [EGC] or advanced gastric cancer [AGC]) were consecutively enrolled. We examined the association of clinical parameters including low serum pepsinogen (PG) I/II ratio < or =3.0 with the disease phenotypes. Histological results between initial forceps-biopsy and endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) specimens were compared. RESULTS: The PG I/II ratio in FD was 4.2+/-1.7, but was significantly low in LGD (2.8+/-1.6, P<0.0001). The ratio was not further decreased in the HGD, EGC, and AGC groups. In FD patients with the ratio of < or =3.0, smoking habits and high salt intake were independent risk factors for gastric dysplasia or gastric cancer. In about 11% (n=8/70) of LGD lesions, the pathologic diagnoses were upgraded to HGD or EGC after endoscopic resection. Neither serious complications nor recurrence at the primary site were found. CONCLUSIONS: It is proposed that endoscopic resection followed by endoscopic surveillance might be a beneficial strategy for patients with LGD having a PG I/II ratio of < or =3.0. |
| Key Words:
Stomach neoplasms; Pepsinogen |
|
PDF Links
Full text via DOI
Download Citation
