Mortensen N J, Thomas W E, Jones S M, Savage A
Br J Surg. 1984 May;71(5):363-7. doi: 10.1002/bjs.1800710519.
Sixty-three partial gastrectomy patients an average 20 years after surgery were reviewed by endoscopy and biopsy in 1977. No cases of invasive carcinoma were found. The patients were then divided into two groups. Those with moderate epithelial dysplasia (13 patients) were reviewed at 6-12 monthly intervals. One patient developed severe dysplasia but none developed an invasive carcinoma. The remaining patients with either no or mild dysplasia were offered endoscopy after 5 years and 24 agreed. Of the 12 patients with no dysplasia at the outset: 5 still had no dysplasia 5 years later, 3 had mild dysplasia and 4 now had moderate dysplasia. There were 12 with mild dysplasia at the first endoscopy, 9 remained unchanged at the review and 3 had moderate dysplasia. If dysplastic changes in gastric mucosa are pre-malignant, progression to invasive carcinoma would appear to be slow. Even 25 years after gastrectomy only a modest deterioration in the grade of dysplasia was found and no invasive cancer.
1977年，对63例平均术后20年的部分胃切除患者进行了内镜检查和活检。未发现浸润性癌病例。然后将患者分为两组。对有中度上皮发育异常的患者（13例）每隔6 - 12个月进行复查。1例患者发展为重度发育异常，但无1例发展为浸润性癌。其余无发育异常或轻度发育异常的患者在5年后接受内镜检查，24例患者同意。最初无发育异常的12例患者中：5年后仍无发育异常，3例有轻度发育异常，4例现在有中度发育异常。首次内镜检查时有12例轻度发育异常，复查时9例无变化，3例有中度发育异常。如果胃黏膜的发育异常变化是癌前病变，那么进展为浸润性癌似乎很缓慢。即使在胃切除25年后，也仅发现发育异常程度有适度恶化，且无浸润性癌。
