Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma.
In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases.Among 146 consecutive patients who underwent endoscopic...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5225017?pdf=render |
| _version_ | 1818520777527394304 |
|---|---|
| author | Hee Kyong Na Charles J Cho Suh Eun Bae Jeong Hoon Lee Young Soo Park Ji Yong Ahn Do Hoon Kim Kee Don Choi Ho June Song Gin Hyug Lee Se Jin Jang Hwoon-Yong Jung |
| author_facet | Hee Kyong Na Charles J Cho Suh Eun Bae Jeong Hoon Lee Young Soo Park Ji Yong Ahn Do Hoon Kim Kee Don Choi Ho June Song Gin Hyug Lee Se Jin Jang Hwoon-Yong Jung |
| author_sort | Hee Kyong Na |
| collection | DOAJ |
| description | In patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases.Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems.Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III-IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively).Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC. |
| first_indexed | 2024-12-11T01:42:12Z |
| format | Article |
| id | doaj.art-3895618742ab48d9b807bddfd8c5b1dd |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T01:42:12Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3895618742ab48d9b807bddfd8c5b1dd2022-12-22T01:25:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01121e016945610.1371/journal.pone.0169456Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma.Hee Kyong NaCharles J ChoSuh Eun BaeJeong Hoon LeeYoung Soo ParkJi Yong AhnDo Hoon KimKee Don ChoiHo June SongGin Hyug LeeSe Jin JangHwoon-Yong JungIn patients with adenoma, assessing premalignant changes in the surrounding mucosa is important for surveillance. This study evaluated atrophic and metaplastic progression in the background mucosa of adenoma or early gastric cancer (EGC) cases.Among 146 consecutive patients who underwent endoscopic resection for intestinal-type gastric neoplasia, the adenoma group included 56 patients with low-grade dysplasia and the ECG group included 90 patients with high-grade dysplasia or invasive carcinoma. For histology, 3 paired biopsies were obtained from the antrum, corpus lesser curvature (CLC), and corpus greater curvature (CGC). Serological atrophy was determined based on pepsinogen A (PGA), progastricsin (PGC), gastrin-17, and total ghrelin levels. Topographic progression of atrophy and/or metaplasia was staged using the operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia assessment (OLGIM) systems.Rates of moderate-to-marked histological atrophy/metaplasia in patients with adenoma were 52.7%/78.2% at the antrum (vs. 58.8%/76.4% in EGC group), 63.5%/75.0% at the CLC (vs. 60.2%/69.7% in EGC group), and 10.9%/17.9% at the CGC (vs. 5.6%/7.8% in EGC group). Serological atrophy indicated by PGA and PGC occurred in 23.2% and 15.6% of cases in the adenoma and ECG groups, respectively (p = 0.25). Mean serum gastrin-17 concentrations of the adenoma group and EGC group were 10.4 and 9.0 pmol/L, respectively (p = 0.54). Mean serum total ghrelin levels were 216.6 and 209.5 pg/mL, respectively (p = 0.71). Additionally, between group rates of stage III-IV OLGA and OLGIM were similar (25.9% vs. 25.0%, p = 0.90; 41.8% vs. 44.9%, p = 0.71, respectively).Atrophic and metaplastic progression is extensive and severe in gastric adenoma patients. A surveillance strategy for metachronous tumors should be applied similarly for patients with adenoma or EGC.http://europepmc.org/articles/PMC5225017?pdf=render |
| spellingShingle | Hee Kyong Na Charles J Cho Suh Eun Bae Jeong Hoon Lee Young Soo Park Ji Yong Ahn Do Hoon Kim Kee Don Choi Ho June Song Gin Hyug Lee Se Jin Jang Hwoon-Yong Jung Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. PLoS ONE |
| title | Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. |
| title_full | Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. |
| title_fullStr | Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. |
| title_full_unstemmed | Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. |
| title_short | Atrophic and Metaplastic Progression in the Background Mucosa of Patients with Gastric Adenoma. |
| title_sort | atrophic and metaplastic progression in the background mucosa of patients with gastric adenoma |
| url | http://europepmc.org/articles/PMC5225017?pdf=render |
| work_keys_str_mv | AT heekyongna atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT charlesjcho atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT suheunbae atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT jeonghoonlee atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT youngsoopark atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT jiyongahn atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT dohoonkim atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT keedonchoi atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT hojunesong atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT ginhyuglee atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT sejinjang atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma AT hwoonyongjung atrophicandmetaplasticprogressioninthebackgroundmucosaofpatientswithgastricadenoma |