Gastric polyps are common precancerous diseases. With the intensive study on the characteristics of different types of gastric polyps in recent years, only 1.7% of the gastric polyps were found to have dysplasia and cancer, and most of the dysplasia and cancer were found in polyps larger than 1 cm. Traditional idea suggests that polyps should be removed immediately, but routine removal of all polyps results in an increased financial burden on patients. At present, there are controversies about whether endoscopic treatment is necessary for different pathological types and small gastric polyps.
Humans ; Hyperplasia ; Polyps ; Precancerous Conditions ; Stomach Neoplasms

Hemangioma/surgery* ; Humans ; Precancerous Conditions ; Sternum/surgery*

Objective: To evaluate the inter-observer agreement of the severity of oral epithelial dysplasia in oral leukoplakia, providing a theoretical basis for the development of a more objective grading system. Methods: This study included 60 digital pathological slides of oral leukoplakia from Oral Medicine Department of West China Hospital of Stomatology, Sichuan University, and 239 tissue microarray images of oral leukoplakia from State Key Laboratory of Oral Diseases, Sichuan University, to evaluate the agreement of grading. Besides, 1 000 patches were generated from the 60 digital pathological slides and were divided into 500 small-sized patches (224 pixel×224 pixel) and 500 large-sized patches (1 024 pixel×1 024 pixel), to evaluate the agreement of feature detection. Gradings and feature detections were completed by three pathological experts from the oral pathology departments of two Grade 3, Class A stomatological hospitals in China. Kappa coefficient was used to quantify the inter-observer agreement among pathologists. Results: Minimal agreement was found in the grading of oral epithelial dysplasia among pathologists (Kappa=0.30 in the pathological slide group, Kappa=0.30 in the tissue microarray group). None agreement was found in feature detection within the small-sized patches group (median Kappa=0.14 for architectural features, median Kappa=0.18 for cytological features), and minimal agreement was found in feature detection within the large-sized patches group (median Kappa=0.25 for architectural features, median Kappa=0.25 for cytological features). Conclusions: Generally, the agreement of grading and feature detection of oral epithelial dysplasia in oral leukoplakia is poor. Development of a more objective grading system of oral epithelial dysplasia based on artificial intelligence may be helpful to improve the agreement.
Artificial Intelligence ; China ; Humans ; Leukoplakia, Oral ; Observer Variation ; Precancerous Conditions

BACKGROUND/AIMS: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. METHODS: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non-MO patients with a prior diagnosis of abnormal esophageal acid exposure. RESULTS: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0.006; 95% confidence interval [CI], 0.001 to 0.075; p=0.000). MO patients were more likely to present with decreased esophageal sensitivity to the instillation of acid than non-MO controls (57% vs 14%; OR, 8; 95% CI, 1.79 to 35.74; p=0.009). Subgroup analysis revealed no differences in esophageal sensitivity in MO patients with and without abnormal esophageal acid exposure (43% vs 31%; p=0.707). CONCLUSIONS: Silent gastroesophageal reflux disease (GERD) is common among MO individuals, likely due to decreased esophageal sensitivity to acid. The absence of typical GERD symptoms in these patients may delay discovery of precancerous conditions, such as Barrett’s esophagus. We believe that these patients may require a more aggressive diagnostic work-up to rule out the presence of silent GERD.
Cross-Sectional Studies ; Diagnosis ; Esophagus ; Gastroesophageal Reflux ; Humans ; Hydrochloric Acid ; Obesity ; Odds Ratio ; Precancerous Conditions

Gastric cancer, the most common cancer in Korea, has come to be more frequently detected in the early stage thanks to regular endoscopy regardless of gastrointestinal symptoms. Early gastric cancer can be treated by endoscopic submucosal dissection or laparoscopic surgery, and its prognosis is very excellent. Thus, it is of an utmost importance to develop efficient screening method and set appropriate interval for the accurate diagnosis of early gastric cancer. Endoscopic screening for every two year is recommended, but the interval could be shortened in case of precancerous condition such as atrophic gastritis and intestinal metaplasia or subjects in a family with a history of gastric cancer. During the investigation, the benefit of using serology of H. pylori infection and serum pepsinogen I/II ratio of less than or equal to 3, instead of direct endoscopy, should also be considered for the selection of a high risk group of gastric cancer in Korea. Recently, appropriate screening and accurate diagnosis of early gastric cancer has become one of the most important issues.
Endoscopy ; Gastritis, Atrophic ; Humans ; Korea ; Laparoscopy ; Mass Screening ; Metaplasia ; Pepsinogen A ; Precancerous Conditions ; Prognosis ; Stomach Neoplasms

The necessity of early detection of prostate cancer renewed interest regarding putative premalignant lesions in the tumorigenesis of the prostate. Prostatic intraepithelial neoplasia (PIN) is one potential precursor for prostatic adenocarcinoma. The term PIN has been adopted to replace a wide range of synonyms in the literature that describe potential precursors. PIN is an intraluminal proliferation of the secretory cells lining architecturally benign prostatic ducts and acini that exhibit cytologic atypia. In this review, we discuss the histologic features, the differential diagnosis, the evidence that PIN is a precursor of prostatic carcinoma, and the clinical significance of PIN.
Adenocarcinoma/*pathology ; DNA, Neoplasm/analysis ; Diagnosis, Differential ; Human ; Male ; Precancerous Conditions/*pathology ; Prostatic Neoplasms/*pathology

Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Female ; Humans ; Hyperplasia ; Lung ; Precancerous Conditions ; Thorax

Barrett's esophagus is now clearly recognized as a preneoplasic condition. Progression of metaplasia through dysplasia to adenocarcinoma is a widely accepted theory for esophageal carcinogenesis. That high grade dysplasia is frequently found in association with esophageal adenocarcinoma. Long-term endoscopic surveillance of high grade dysplasia in Barrett's esophagus facilitates detection and treatment of esophageal cancers in the early stage.
Barrett Esophagus ; diagnosis ; pathology ; therapy ; Esophageal Neoplasms ; diagnosis ; Esophagoscopy ; Humans ; Hyperplasia ; pathology ; Precancerous Conditions ; diagnosis

Carcinoma, Hepatocellular ; pathology ; Diagnosis, Differential ; Humans ; Liver Cirrhosis ; pathology ; Liver Neoplasms ; pathology ; Precancerous Conditions ; pathology

Carcinoma, Hepatocellular ; pathology ; Humans ; Hyperplasia ; Liver ; pathology ; Liver Neoplasms ; pathology ; Precancerous Conditions ; pathology