Gastric dysplasia : a clinical and pathological analysis.

• Main Author: Lee, Jocelyn Shi Ting.
• Other Authors: School of Biological Sciences
• Format: Final Year Project
• Language: English
• Published: 2013
• Subjects: DRNTU::Science
• Online Access: http://hdl.handle.net/10356/52944
• Institution: Nanyang Technological University

Introduction: The intestinal- type gastric cancer carcinogenesis pathway is a series of multistep histological events. Gastric dysplasia, a premalignant lesion, occurs just before gastric cancer develops. It is characterised by cytological and architectural changes. However, the distinction in the grade of dysplasia is somewhat controversial with different systems (Japanese and Western) in place and also due to inflammation and reactive changes. In the Vienna classification, dysplasia is grouped into low grade, high grade and indefinite. Changes are not clear cut and unequivocal in indefinite dysplasia. Aim: To investigate the (1) Incidence of dysplasia, including indefinite dysplasia (2) Follow- up progression of indefinite dysplasia (3) Histological criteria with progression of indefinite dysplasia Results: The risk of progression to gastric adenocarcinoma increases with increasing age and showed male biasness. Out of 74 indefinite cases, 16 (21.6%) showed progression of indefinite dysplasia (median age 61.5). The follow- up biopsy time showed statistical significance (p= 0.003) with the progression of indefinite dysplasia. However, clinical and histological features were shown to be independent risk factors. Conclusion: The shorter follow- up time seen in the progression of indefinite dysplasia can be indicative of high clinical suspicion, suggesting that patients should be kept under close surveillance to provide for an early therapeutic window.