[Superficial gastric cancer in Barcelona. Importance of the detection of severe epithelial dysplasia in biopsies obtained under endoscopic control in the diagnosis of early gastric cancer].

BACKGROUND

Severe mucosal dysplasia (SMD) in endoscopic gastric biopsies is a controversial lesion because some authors consider it as an histologic lesion associated to superficial gastric cancer (SCG). This study is aimed to asses the prevalence of SCG in Barcelona; if the presence of SMD is associated to SCG and, the clinical and endoscopic manifestations which induced the diagnosis.

METHODS

We studied a total of 4,800 patients who had been submitted to gastroscopy during 1.5 years. A total of 79 patients suffered gastric cancer, 56 of them were submitted to resection. Ten of these 56 patients (17%) had SCG. The most frequent first clinical manifestation of SCG was gastrointestinal haemorrhage.

RESULTS

Endoscopic aspect suggested malignancy in five cases. Biopsies during endoscopy allow diagnosis of gastric cancer in five. In four histologic studies showed SMD. In the tenth patient, the first endoscopy with biopsies showed a gastric peptic ulcer. A later endoscopic control showed the persistence of the macroscopically benign lesion but one among seven biopsies showed adenocarcinoma. The four patients with SMD had gastric cancer in further endoscopic procedures, except in one which was operated after two endoscopies demonstrating SMD.

CONCLUSIONS

This study suggests: 1) prevalence of SGC in Barcelona is similar than the other European countries. 2) haemorrhage is a frequent first manifestation of SCG, and 3) the finding of SMD in endoscopic biopsy strongly suggests the presence of SCG in the stomach.