Serov V V, Aruin L I, Rottenberg V I, Sklianskaia O A, Smotrova I A
Arkh Patol. 1985;47(11):6-13.
Biopsy and operative material was used to study the incidence and significance of different degrees of dysplasia in precancerous diseases and gastric cancer, its evolution and pathognomonic features, with various morphological methods. It is shown that mild and moderate dysplasia is indistinguishable from regenerative changes in gastritis, erosions and gastric ulcer, it can undergo involution or malignization. A marker of enhanced risk of gastric cancer is severe dysplasia which is often multicentric. Among pretumor diseases, most frequently severe dysplasia is found with adenoma and gastritis of the stump. Severe dysplasia in the absence of cancer in the gastrobiopsy material makes mandatory a dynamic study with biopsies taken every three months from different regions of the mucosa. The degree of dysplasia can be objectively tested by quantitating the DNA content, and its average content can be a criterion for differential diagnosis between severe dysplasia and early cancer. The histochemical, radioautographic, and electron microscopic features of dysplasia, testifying to impaired regeneration of te epithelium, cannot serve to differentiate between severe dysplasia and cancer or to assess the risk of transition of dysplasia into cancer. The main way of solving this problem is dynamic observation.
采用多种形态学方法，利用活检和手术材料研究癌前疾病及胃癌中不同程度发育异常的发生率和意义、其演变过程及病理特征。结果表明，轻度和中度发育异常与胃炎、糜烂及胃溃疡中的再生性改变难以区分，其可发生消退或恶变。胃癌风险增加的一个标志是重度发育异常，其常为多中心性。在癌前疾病中，重度发育异常最常见于腺瘤和残胃炎。胃活检材料中无癌但存在重度发育异常时，必须进行动态研究，每三个月从黏膜不同区域取活检。发育异常程度可通过定量DNA含量进行客观检测，其平均含量可作为重度发育异常与早期癌鉴别诊断的标准。发育异常的组织化学、放射自显影及电子显微镜特征表明上皮再生受损，但不能用于区分重度发育异常与癌，也不能评估发育异常转变为癌的风险。解决这一问题的主要方法是动态观察。
