Clinical Gastroenterology Vol.21 No.6(5)

Theme Preventive Medicine of Gastrointestinal Cancer
Title Clinical Management of High Risk Lesions of Gastric Cancer
Publish Date 2006/06
Author Takahiro Kozu Endoscopy Division, National Cancer Center Hospital
Author Daizo Saito Endoscopy Division, National Cancer Center Hospital
[ Summary ] For optimal management of precancerous gastric cancer lesions, it is important to know about site, incidence of becoming malignant, and speed of progression. Remnant stomach, post endoscopic treatment state of gastric cancer, adenoma, and atrophic gastritis are considered as high risk gastric cancer factors. For adenoma, it can in principle be followed up without resection. However, it is sometimes difficult to differentiate benign tissue from carcinoma, even by biopsy diagnosis. Therefore, in those cases, diagnostic endoscopic resection is recommended. For post surgical treatment of gastric cancer, we should have detailed information about any treatment that was given before our examination. Also, the high frequency of metachronous gastric cancers after initial endoscopic resection requires annual follow-up by endoscopy. Gastritis with atrophic changes in broad area and metaplasia is also considered to be a high risk factor for gastric cancer. Helicobacter pylori eradication therapy is now under review.
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