Efficacy and Safety of Radiofrequency Ablation for Treatment of Low-Grade Gastric Epithelial Dysplasia: Results from the Animal Study and Clinical Trials

Abstract

Background and study aims: Gastric low-grade dysplasia (LGD) is considered an precancerous lesion and can progress to invasive carcinoma. According to the Vienna classification, a diagnosis of LGD (category3) with forceps biopsy suggests endoscopic resection or follow up. We describe our initial experience regarding safety and efficacy of radiofrequency ablation (RFA) therapy in treating patients with LGD. Methods: This study includes animal experiments and clinical studies. We carried out RFA with two pigs in vivo. The clinical trials carried out on the basis of animal experiments results. We prospectively enrolled 114 patients with LGD who were treated with RFA at the General Hospital of PLA. Results: 2 pigs were successfully treated with radiofrequency ablation. With increasing frequency of radiofrequency the edema and congestion became obviously and With increasing of the RFA frequency the depth of interaction RFA became deepen. The 114 patients of LGD have 128 lesions that were underwent RFA procedures, which based the size of the lesion and were burning 2-12 times / person, average 5.25 times / person. There were no complications occurred in the RFA procedure. Postoperative complications is abdominal pain, 89 patients was follow-up, which contains 101 lesions, residual 5 cases, 7 / 89, 7.87%; elimination rate of 92.13%, 82/89. 20 patients with abdominal pain(20/89, 22.47%). Conclusion: RFA can be an effective treatment of LGD to previous endoscopic therapy. Additional studies are needed to identify which subset of patients will benefit the most with RFA treatment.