Gastric intraepithelial neoplasia in a Western population
MetadataShow full item record
Background and study aims: Descriptions of the natural history and endoscopic appearances of gastric dysplasia/ intraepithelial neoplasia (IEN) that originate mainly from Europe. Currently, there are no Australian data available. We aimed to document endoscopic appearances and progression rates of gastric IEN and to determine the significance of indefinite for IEN. Patients and methods: This is a retrospective study, in which cases diagnosed with gastric IEN were identified between 2000 and 2009. Endoscopic appearances, progression rates to more advanced IEN or cancer, and long-term outcomes were recorded. Results: A total of 160 cases with IEN (26.9% high grade, 57.5% low grade, 15.6% indefinite) were identified. The mean age was 67.8 years and 53.8% were men. Endoscopic lesions were polypoid in 29.4% and nonpolypoid in 70.6%. The most common location was the antrum (58.7%). Forty patients had an intervention and 76 underwent endoscopic follow-up only. Twenty-two cancers were diagnosed; three who had an intervention were diagnosed within 12 months, one with low-grade intraepithelial neoplasia developing a cancer after 9.9 years, and 13 undergoing surveillance only, were diagnosed with cancer within 12 months of index endoscopy. Five cases had cancer after a mean of 2.6 years. Forty-seven cases initially labelled as indefinite; following rereview 25 remained unchanged, 11 reclassified as negative for IEN, 10 as low grade, and one as high grade. Three of these cases developed cancer over the study period. Conclusion: We concluded that (a) majority of gastric IEN are associated with endoscopic lesions, (b) high rate of early cancer diagnosis was observed (c) rates of progression to cancer were lower than reported rates, and (d) indefinite for IEN is not innocuous requiring an expert pathologist’s review.
Showing items related by title, author, creator and subject.
Outcomes of screening gastroscopy in first-degree relatives of patients fulfilling hereditary diffuse gastric cancer criteriavan der Post, R.; van Dieren, J.; Grelack, A.; Hoogerbrugge, N.; van der Kolk, L.; Snaebjornsson, P.; Lansdorp-Vogelaar, Iris; van Krieken, J.; Bisseling, T.; Cats, A. (2017)Background and Aims: The aim of this study was to determine the yield of endoscopic screening in first-degree relatives (FDRs) of CDH1-negative hereditary diffuse-type gastric cancer (HDGC) patients. Methods: In this ...
Neratinib after trastuzumab-based adjuvant therapy in patients with HER2-positive breast cancer (ExteNET): A multicentre, randomised, double-blind, placebo-controlled, phase 3 trialChan, Arlene; Delaloge, S.; Holmes, F.; Moy, B.; Iwata, H.; Harvey, V.; Robert, N.; Silovski, T.; Gokmen, E.; von Minckwitz, G.; Ejlertsen, B.; Chia, S.; Mansi, J.; Barrios, C.; Gnant, M.; Buyse, M.; Gore, I.; Smith, J.; Harker, G.; Masuda, N.; Petrakova, K.; Zotano, A.; Iannotti, N.; Rodriguez, G.; Tassone, P.; Wong, A.; Bryce, R.; Ye, Y.; Yao, B.; Martin, M. (2016)Background: Neratinib, an irreversible tyrosine-kinase inhibitor of HER1, HER2, and HER4, has clinical activity in patients with HER2-positive metastatic breast cancer. We aimed to investigate the efficacy and safety of ...
Rates of colonoscopy in the 3 years prior to a diagnosis of colorectal cancer in Western Australia: assessment of risk factors for missed and interval cancers. Preliminary results from a population-based studySalama, M.; Harma, C.; Fritschi, Lin; Heyworth, J.; Raftopoulos, S.; Ee, H. (2014)Introduction and Aims: Colonoscopy is the gold standard for diagnosing colorectal cancer (CRC) however there is a miss rate for cancers of up to 7.9%, with significant variability in this figure from different populations ...