Clinical Parameters Including Serum Pepsinogen Level and Management Strategy in Patients with Gastric Low-Grade Dysplasia.
10.7704/kjhugr.2011.11.1.52
- Author:
Jun Hyung CHO
1
;
Young Woon CHANG
;
Young HWANGBO
;
Jaejun SHIM
;
Jae Young JANG
;
Hyo Jong KIM
;
Byung Ho KIM
Author Information
1. Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea. cywgi@chollian.net
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Pepsinogen
- MeSH:
Dyspepsia;
Follow-Up Studies;
Humans;
Pepsinogen A;
Phenotype;
Recurrence;
Risk Factors;
Smoke;
Smoking;
Stomach Neoplasms
- From:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
2011;11(1):52-58
- CountryRepublic of Korea
- Language:Korean
-
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.
