Morson B C, Sobin L H, Grundmann E, Johansen A, Nagayo T, Serck-Hanssen A
J Clin Pathol. 1980 Aug;33(8):711-21. doi: 10.1136/jcp.33.8.711.
A distinction can be made between a precancerous condition and a precancerous lesion. The former is a clinical state associated with a significantly increased risk of cancer, whereas a precancerous lesion is a histopathological abnormality in which cancer is more likely to occur than in its apparently normal counterpart. Up to the present time atrophic gastritis, gastric ulcer, pernicious anaemia, gastric stumps, gastric polyps, and Ménétrier's disease have all been considered as precancerous conditions and lesions of the stomach. Of these, only atrophic gastritis, pernicious anaemia, gastric stumps, and certain types of gastric polyp can now be regarded as having any really significant malignant potential. The precancerous lesion common to these is epithelial dysplasia which can occur in ordinary (foveolar) gastric epithelium as well as in intestinal metaplasia. The criteria for grading dysplasia in gastric epithelium into mild, moderate, and severe grades are given, and attention is drawn to the problems of differentiating inflammatory or regenerative change from mild dysplasia and intramucosal carcinoma from severe dysplasia. The clinical and epidemiological implications of gastric dysplasia are discussed with suggestions for further research.
癌前状态和癌前病变是有区别的。前者是一种与癌症风险显著增加相关的临床状态，而癌前病变是一种组织病理学异常，其中发生癌症的可能性比其明显正常的对应物更高。截至目前，萎缩性胃炎、胃溃疡、恶性贫血、胃残端、胃息肉和门脉高压性胃病都被认为是胃的癌前状态和病变。其中，目前只有萎缩性胃炎、恶性贫血、胃残端和某些类型的胃息肉可被视为具有真正显著的恶变潜能。这些病变共有的癌前病变是上皮发育异常，其可发生于普通（小凹）胃上皮以及肠化生中。给出了将胃上皮发育异常分级为轻度、中度和重度的标准，并提请注意区分炎症或再生性改变与轻度发育异常以及区分黏膜内癌与重度发育异常的问题。讨论了胃发育异常的临床和流行病学意义，并提出了进一步研究的建议。
