A follow-up study of 370 patients with gastric intraepithelial neoplasias and cancer screening

Abstract

Objective To explore the outcomes and gastric cancer screening within gastric intraepi- thelial neoplasia patients. Methods Data of 370 patients with gastric intraepithelial neoplasia （IEN） con- firmed by endoscopic biopsy in digestive clinic in Ruijin Hospital were coUected. All subjects received regu- lar follow-ups and endoscopic reviews to monitor the outcomes and to study the incidence of gastric cancer misdiagnosis. Results The intraepithelial neoplasia lesions were mainly located in the low part of stomach （81.62%）. The endoscopic features of 290 cases of LGIEN were erosion （29. 31% ） and multiple hyperpla- sia lesions （23.45%）, while that of HGIEN group was ulcerations （58. 57% ）. In the LGIEN group, there were 186 cases （64. 14% ） of regression, 8 cases （2. 76% ） of HGIEN and 26 cases （8. 97% ） of gastric cancer at the end of the research. In the I-IGIEN group, only 16 cases （20. 00% ） were regression, 18 cases （22. 50% ） of LGIEN, 12 cases （15.00%） HGIEN, and 34 others （42. 50% ） of cancer, which were far more than those of LGIEN group （P 〈 0. 0001 ）. The detection rates of gastric cancer of both groups were significantly higher than the general population. There were 19 cases among all the confirmed cancer patients misdiagnosed or possibly misdiagnosed. The rate of misdiagnosis or suspected misdiagnosis was 31.67%. Conclusion Patients with intraepithelial neoplasia diagnosed by endoscopic biopsy might have cancer. Close and standardized endoscopic follow-ups must be carried out timely in order to reduce the incidence of missed gastric cancer, especially for patients with ulcerative lesions or HGIEN confirmed with biopsy. Key words: Gastric intraepithelial neoplasia; Gastric cancer; Screening; Follow-up