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KMID : 0931320110110010052
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대한상부위장관.헬리코박터학회지
2011 Volume.11 No. 1 p.52 ~ p.58
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Clinical Parameters Including Serum Pepsinogen Level and Management Strategy in Patients with Gastric Low-Grade Dysplasia
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Cho Jun-Hyung
Hwangbo Young
Shim Jae-Jun
Jang Jae-Young
Kim Hyo-Jong
Kim Byung-Ho
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Abstract
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Background/Aims: There are no proper guidelines for the management of gastric low-grade dysplasia (LGD). We evaluated clinical parameters, histological results and follow-up endoscopies to find a management strategy of LGD.
Materials and Methods: A total of 590 patients with LGD, high-grade dysplasia (HGD), functional dyspepsia (FD), early or advanced gastric cancer (early gastric cancer [EGC] or advanced gastric cancer [AGC]) were consecutively enrolled. We examined the association of clinical parameters including low serum pepsinogen (PG) I/II ratio ≤3.0 with the disease phenotypes. Histological results between initial forceps-biopsy and endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) specimens were compared.
Results: The PG I/II ratio in FD was 4.2±1.7, but was significantly low in LGD (2.8±1.6, P＜0.0001). The ratio was not further decreased in the HGD, EGC, and AGC groups. In FD patients with the ratio of ≤3.0, smoking habits and high salt intake were independent risk factors for gastric dysplasia or gastric cancer. In about 11% (n=8/70) of LGD lesions, the pathologic diagnoses were upgraded to HGD or EGC after endoscopic resection. Neither serious complications nor recurrence at the primary site were found.
Conclusions: It is proposed that endoscopic resection followed by endoscopic surveillance might be a beneficial strategy for patients with LGD having a PG I/II ratio of ≤3.0
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KEYWORD
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Stomach neoplasms, Pepsinogen
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