John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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How to optimize the monitoring of pre-neoplastic gastric lesions? Volume 26, issue 7, Septembre 2019

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Authors
1 Hôpital Européen Georges Pompidou, Service d’hépato-gastroentérologie et endoscopies digestives, 20 rue Leblanc, 75015 Paris
2 Hôpital Ambroise Paré, Service d’anatomie et cytologie pathologiques, 9 avenue Charles de Gaulle, 92104 Boulogne-Billancourt
3 Hôpital Ambroise Paré, Service d’hépato-gastroentérologie, 9 avenue Charles de Gaulle, 92104 Boulogne-Billancourt
* Correspondance

The majority of gastric cancer is originated from pre-neoplastic lesions that appear in the previous years. These lesions are dysplasia and, more improperly for pathologists, the atrophy and intestinal metaplasia of the gastric mucosa most often induced by an old Helicobacter pylori infection. Atrophy of the gastric body associated with intestinal metaplasia is a particular risk factor for cancer. There is a beneficial effect of eradication of H. pylori on the development of preneoplastic lesions which have not reached the stage of intestinal metaplasia. In this case monitoring every 3 years is recommended particularly in patients with extensive lesions in the gastric body and antrum or severe lesions whatever the location. In the case of low-grade dysplasia discovered on biopsies, annual endoscopic monitoring is recommended.

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