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

Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Precancerous Conditions ; diagnosis ; Stomach Neoplasms ; diagnosis

OBJECTIVETo investigate the histopathological subjective difference of laryngeal epitheliual premalignant lesions and to analyze the prognosis of every grade of laryngeal epitheliual premalignant lesion.

METHODSAccording to 2005 WHO classification system, 237 cases of laryngeal epitheliual premalignant lesions were reviewd by 3 pathologists, meanwhile, the histopathological consistency among 3 pathologists was estimated with κ-statistics method. The Kaplan-Meier survival analysis were performed to assess the prognosis of every grade of laryngeal epitheliual premalignant lesion with follow-up data.

RESULTSThere was totally a moderate consistency among 3 pathologists (κ values: 0.598 9), the histopathological difference was mainly between mild dysplasia and moderate dysplasia and between severe dysplasia and carcinoma in situ. The follow-up duration was between 18-120 months, and the median follow-up duration was 38 months. The carcinoma trsnformation rate was 8.44% (20/237) with an average malignant transformation duration of (19.45 ± 7.32) months, which was increased with the degree of dysplasia(mild dysplasia:1.67%, moderate dysplasia:3.57%, severe dysplasia:10.60%, carcinoma in situ:18.18%), no difference could be found between mild and moderate dysplasia, between moderate and severe dysplasia; Moreover, there was no difference between severe dysplasia and carcinoma in situ (P > 0.05).

CONCLUSIONSThe histopathological variability brought the uncertainty for classification of laryngeal epitheliual premalignant lesions, which might have an impact on clinical management of laryngeal epitheliual premalignant lesions; there was obvious difference in carcinoma transformation between low-risk and high-risk laryngeal epitheliual premalignant lesions, and more attention on treatment and prognosis assessment should be paid for severe dysplasia as carcinoma in situ.

Cell Transformation, Neoplastic ; Humans ; Hyperplasia ; Laryngeal Diseases ; Laryngeal Neoplasms ; diagnosis ; Larynx ; Male ; Precancerous Conditions ; diagnosis ; Prognosis

China ; epidemiology ; Humans ; Precancerous Conditions ; diagnosis ; epidemiology ; pathology ; Stomach Neoplasms ; diagnosis ; epidemiology ; pathology ; Topography, Medical

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

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

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

Chronic atrophic gastritis (CAG), a chronic disease of the digestive system resulting from multi-pathogenic factors, is precancerous state of gastric cancer. Authors reviewed the current situation of Chinese medical diagnosis and treatment of CAG, and looked forward to its prospect by combining with their own clinical experience and scientific researches.
Chronic Disease ; Gastritis, Atrophic ; diagnosis ; therapy ; Humans ; Medicine, Chinese Traditional ; Precancerous Conditions ; Stomach Neoplasms

BACKGROUNDIn the recent years, the incidence of esophageal cancer in China has increased. The key point for raising the survival rate is the diagnosis and treatment at an early stage. Narrow-band imaging (NBI) can enhance the contrast of the mucous membrane of the esophagus without staining. This study aimed to explore the value of NBI in the diagnosis of early esophageal cancer and precancerous lesions.

METHODSThe esophagus was examined with ordinary endoscopy and NBI endoscopy. Pit patterns and blood capillary forms were examined with routine magnifying endoscopy and NBI endoscopy. Finally, a 1.2% Lugoul's iodine solution was used to stain the esophageal mucosal surface and a biopsy was taken at all the sites where NBI or iodine staining was positive. NBI and iodine staining scales were compared with pathologic diagnosis, which was considered as the gold standard.

RESULTSA total of 90 cases (138 lesions in total) were diagnosed as early esophageal cancer or precancerous lesions; 104 lesions (75.4%) were detected with ordinary endoscopy, 120 lesions (87.0%) were detected with NBI endoscopy, and 138 lesions (100%) were detected with iodine staining. The lesion detection rate of NBI was significantly lower than that of iodine staining (chi(2) = 17.176, P < 0.01). However, there was no significant difference between NBI and iodine staining for the diagnosis of high grade intraepithelial neoplasia (chi(2) = 1.362, P > 0.05), while the detection rate of NBI was significantly lower than that of iodine staining for the diagnosis of low grade intraepithelial neoplasia (chi(2) = 13.388, P < 0.01). The pit pattern and blood capillary form of early esophageal cancer and precancerous lesions could be demonstrated clearer with NBI than with ordinary endoscopy.

CONCLUSIONSNBI can enhance the contrast of the mucous membrane of the esophagus without staining. The combination of NBI and iodine staining can raise the diagnostic rate of early esophageal cancer and precancerous lesions.

Adult ; Aged ; Esophageal Neoplasms ; diagnosis ; pathology ; Esophagoscopy ; methods ; Esophagus ; pathology ; Female ; Humans ; Male ; Middle Aged ; Precancerous Conditions ; diagnosis ; pathology

OBJECTIVETo assess autofluorescence endoscopy in the diagnosis of early laryngeal cancer and its precancerous lesions.

METHODSSeventy five patients suspected of having precancerous or cancerous lesions were examined with autofluorescence endoscopy (filtered blue light 380460 nm) under microlaryngoscopy. Autofluorescence pictures were taken with high-solution CCD-camera for analysis, diagnosis and storage, to compare with histologic results.

RESULTSNormal laryngeal mucosa with no visible alteration and mild hyperplasia displayed the typical bright green fluorescence signal, and the areas with moderate dysplasia, severe dysplasia or carcinoma in situ, microinvasive carcinoma and infiltrating carcinoma all showed a marked change in fluorescence to red or violet. Thus, autofluorescence enables to distinguish between benign hyperplastic laryngeal lesions (n =30) and precancerous epithelium (n =45) with a sensitivity rate of 97.8%, and specificity rate of 86.7%. False-negative results (n = 1) were caused by extreme hyperkeratosis, and false positive (n = 4) were cases with scarring or inflammation.

CONCLUSIONSAutofluorescence endoscopy is a less invasive method of diagnosing laryngeal cancer and its precursor, which can be manipulated easily and has high sensitivity. But there are considerable false-positive rates.

Adult ; Aged ; Early Detection of Cancer ; Endoscopy ; methods ; Female ; Fluorescence ; Humans ; Laryngeal Neoplasms ; diagnosis ; Male ; Middle Aged ; Precancerous Conditions ; diagnosis