Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up

Article Abstract:

Gastric cancer, a disease associated with significant mortality, is much more successfully treated when detected early than when detected later in the course of its development. In most published studies, 5-year survival rates do not exceed 15 percent. It is thought that frequent screening is particularly important for the early detection of gastric cancer in patient populations who are particularly susceptible to this disease, such as those with abnormalities of gastrointestinal cellular development. To evaluate possible changes in patterns of gastric cancer diagnosis over time and to investigate the utility of frequent screening in high-risk patients, the records of 718 patients who underwent gastrectomy (stomach removal) for gastric cancer between 1976 and 1987 were reviewed. During the second six-year portion of the study, all patients diagnosed with type III intestinal metaplasia (an abnormal condition of the intestinal cells that sometimes presages the onset of gastric cancer) were closely followed up and repeatedly screened for gastric cancer. In 24 of these patients (3.3 percent), gastrectomy was performed in the course of treatment for early (rather than advanced) gastric cancer. Six of the 24 patients were diagnosed in the first six-year period of the study; 18 of the 24 were diagnosed in the second six-year period, indicating that a significantly higher percentage was diagnosed in the more recent period. Eleven of the 18 patients (61 percent) diagnosed with early gastric cancer were diagnosed as a direct result of the increased frequency of screening following the discovery of intestinal metaplasia. Hence, frequent screening for gastric cancer in patients at risk for this condition is an effective method of diagnosing gastric cancer at an early stage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Gastrointestinal diseases, Stomach cancer, Endoscopy, Metaplasia

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Variants of intestinal metaplasia in the evolution of chronic atrophic gastritis and gastric ulcer. A follow up study

Article Abstract:

Early detection of stomach and intestinal cancer greatly improves the chances for survival. Metaplasia (a conversion from one cell type to another) of the cells lining the stomach and intestine often precedes the development of cancerous lesions, as well as the onset of gastritis (stomach inflammation) and ulcers. However, these metaplastic changes are often harmless, and spontaneously remission can occur. A better understanding of the nature and time course of metaplasia in precancerous and non-precancerous organs will lead to better diagnostic strategies for the early detection of cancer. Patients with gastric ulcer (66 patients) or non-ulcer chronic gastritis (58 patients), all of whom exhibited intestinal metaplasia, were studied over a period ranging from one to six years. Three types of metaplasia characterized by different degrees of cellular alteration were seen at initial biopsy. These three types were typically associated with different types of gastrointestinal disease, and exhibited distinctive progressions and remissions. It is suggested that multiple biopsies be taken from six sites most likely to be involved in the development of stomach cancer; that a standardized system of describing metaplastic progression be adopted; and that three- to five-year follow-up periods be used. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Abnormalities, Precancerous conditions, Gastrointestinal system, Stomach, Endoscopic surgery, Intestinal mucosa

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