위 이형성의 임상 - 병리학적 검색

Background/Aims: Gastric dysplasia is defined as epithelial changes showing prominent cellular and structural abnormabties and is believed to be a precancerous lesion. Methods: We analysed 122 cases which were diagnosed to have gastric dysplasia during the last 4 years (from 1991 to 1995). Results: There were 27 cases of low grade dysplasia (LGD) and 40 cases of high grade dysplasia (HGD) with follow-up biopsies. Follow-up durations of LGD were 0.2-36 months (mean; 8.7 months) and those of HGD were 0.3-30 months (mean; 7.3 months). Follow-up biopsies were performed by endoscopic biopsy, laser polypectomy or mucosectomy, and gastrectamy. Four follow-up biopsies out of 27 cases of LGD turned out to be HGD (3 cases) or adenocarcinoma (1 case). In the follow-up biopsies of 40 HGD cases, 25 cases turned out to be HGD (62.5%), and 12 cases were adenocarcinoma (30%, 11 cases of early gastric cancer and 1 case of advanced gastric cancer). On endoscopic findings, 81.1% of LGD and 56.1% of HGD were superficially elevated or polypoid type, while 18.9% of LGD and 43.9% of HGD were supcrficially depressed or excavated type. Conclusions: Low grade dysplasia had a tendency to persist. High grade dysplasia was closely related to adenocarcinoma or appeared to progress to adenocarcinoma. Endoscopic findings as well as histological features should be considered for the diagnosis of gastric dysplasia. (Kor J Gastroenterol 1998;32:169 - 175)