Koch H K, Oehlert M, Oehlert W
Gemeinschaftspraxis für Pathologie, Freiburg, FRG.
Pathol Res Pract. 1990 Feb;186(1):80-4. doi: 10.1016/S0344-0338(11)81013-7.
Since the fate and significance of gastric mucosal dysplasia is still largely unknown we have started a follow-up study for patients with dysplasia in the years 1986 and 1987. In this paper the short term results are reported. Dysplasia grade II was found in 2% of all patients and dysplasia grade III in 0.5%. The following results suggest a close-possibly sequential relationship of dysplasia and gastric cancer: dysplasia and gastric cancer are preferentially located in distal parts of the stomach; sex distribution of dysplasia and gastric cancer (especially intestinal type) are similar; considering the mean age of patients with dysplasia or gastric cancer we have observed that patients with dysplasia II were younger than patients with dysplasia III and both were younger than patients with gastric cancer of the intestinal type; during the short term follow-up (12-24 months) 4-8% of patients with dysplasia II and 18-20% of patients with dysplasia III showed a progression; of 26 carcinomas detected by follow-up of patients with dysplasia III 10 were early gastric cancer, 11 resectable with curative intent, 2 were metastatic and 3 without sufficient information for staging. We conclude therefore that gastric dysplasia is probably a true precancerous lesion that helps to identify high risk patients and thus contributes to the objective of an early diagnosis of gastric cancer.
由于胃黏膜发育异常的转归和意义在很大程度上仍不清楚，我们于1986年和1987年开始了对发育异常患者的随访研究。本文报告了短期结果。在所有患者中，2%发现有II级发育异常，0.5%发现有III级发育异常。以下结果提示发育异常与胃癌之间可能存在密切的、或许是相继的关系：发育异常和胃癌都好发于胃的远端；发育异常和胃癌（尤其是肠型）的性别分布相似；考虑到发育异常或胃癌患者的平均年龄，我们观察到II级发育异常患者比III级发育异常患者年轻，且二者都比肠型胃癌患者年轻；在短期随访（12 - 24个月）中，II级发育异常患者中有4 - 8%出现进展，III级发育异常患者中有18 - 20%出现进展；在对III级发育异常患者进行随访时检测到的26例癌中，10例为早期胃癌，11例可进行根治性切除，2例有转移，3例分期信息不足。因此，我们得出结论，胃发育异常可能是一种真正的癌前病变，有助于识别高危患者，从而有助于实现胃癌早期诊断的目标。
