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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1980 Aug;33(8):711–721. doi: 10.1136/jcp.33.8.711

Precancerous conditions and epithelial dysplasia in the stomach.

B C Morson, L H Sobin, E Grundmann, A Johansen, T Nagayo, A Serck-Hanssen
PMCID: PMC1146204  PMID: 7430384

Abstract

A distinction can be made between a precancerous condition and a precancerous lesion. The former is a clinical state associated with a significantly increased risk of cancer, whereas a precancerous lesion is a histopathological abnormality in which cancer is more likely to occur than in its apparently normal counterpart. Up to the present time atrophic gastritis, gastric ulcer, pernicious anaemia, gastric stumps, gastric polyps, and Ménétrier's disease have all been considered as precancerous conditions and lesions of the stomach. Of these, only atrophic gastritis, pernicious anaemia, gastric stumps, and certain types of gastric polyp can now be regarded as having any really significant malignant potential. The precancerous lesion common to these is epithelial dysplasia which can occur in ordinary (foveolar) gastric epithelium as well as in intestinal metaplasia. The criteria for grading dysplasia in gastric epithelium into mild, moderate, and severe grades are given, and attention is drawn to the problems of differentiating inflammatory or regenerative change from mild dysplasia and intramucosal carcinoma from severe dysplasia. The clinical and epidemiological implications of gastric dysplasia are discussed with suggestions for further research.

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Selected References

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  1. BOYD J., LANGMAN M., DOLL R. THE EPIDEMIOLOGY OF GASTROINTESTINAL CANCER WITH SPECIAL REFERENCE TO CAUSATION. Gut. 1964 Apr;5:196–200. doi: 10.1136/gut.5.2.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CHUSID E. L., HIRSCH R. L., COLCHER H. SPECTRUM OF HYPERTROPHIC GASTROPATHY; GIANT RUGAL FOLDS, POLYPOSIS, AND CARCINOMA OF THE STOMACH--CASE REPORT AND REVIEW OF THE LITERATURE. Arch Intern Med. 1964 Nov;114:621–628. doi: 10.1001/archinte.1964.03860110091008. [DOI] [PubMed] [Google Scholar]
  3. Correa P., Cuello C., Duque E., Burbano L. C., Garcia F. T., Bolanos O., Brown C., Haenszel W. Gastric cancer in Colombia. III. Natural history of precursor lesions. J Natl Cancer Inst. 1976 Nov;57(5):1027–1035. doi: 10.1093/jnci/57.5.1027. [DOI] [PubMed] [Google Scholar]
  4. Correa P., Cuello C., Duque E. Carcinoma and intestinal metaplasia of the stomach in Colombian migrants. J Natl Cancer Inst. 1970 Feb;44(2):297–306. [PubMed] [Google Scholar]
  5. Cuello C., López J., Correa P., Murray J., Zarama G., Gordillo G. Histopathology of gastric dysplasias: correlations with gastric juice chemistry. Am J Surg Pathol. 1979 Dec;3(6):491–500. doi: 10.1097/00000478-197912000-00002. [DOI] [PubMed] [Google Scholar]
  6. DE JODE L. R. Gastric carcinoma following gastro-enterostomy and partial gastrectomy. Br J Surg. 1961 Mar;48:512–514. doi: 10.1002/bjs.18004821108. [DOI] [PubMed] [Google Scholar]
  7. DOLL R., JONES F. A., PYGOTT F., STUBBE J. L. The risk of gastric cancer after medical treatment for gastric ulcer. Gastroenterologia. 1957;88(1):1–12. doi: 10.1159/000201604. [DOI] [PubMed] [Google Scholar]
  8. Dudley F. J., Fox R. A., Sherlock S. Relationship of hepatitis-associated antigen (H.A.A.) to acute and chronic liver injury. Lancet. 1971 Jul 3;2(7714):1–3. doi: 10.1016/s0140-6736(71)90001-8. [DOI] [PubMed] [Google Scholar]
  9. Elsborg L., Andersen D., Myhere-Jensen O., Bastrup-Madsen P. Gastric mucosal polyps in pernicious anaemia. Scand J Gastroenterol. 1977;12(1):49–52. [PubMed] [Google Scholar]
  10. Elster K. Histologic classification of gastric polyps. Curr Top Pathol. 1976;63:77–93. doi: 10.1007/978-3-642-66481-6_3. [DOI] [PubMed] [Google Scholar]
  11. Griffiths C. T., Grogan R. H., Hall T. C. Advanced ovarian cancer: primary treatment with surgery, radiotherapy, and chemotherapy. Cancer. 1972 Jan;29(1):1–7. doi: 10.1002/1097-0142(197201)29:1<1::aid-cncr2820290102>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  12. Grundmann E. Histologic types and possible initial stages in early gastric carcinoma. Beitr Pathol. 1975;154(3):256–280. doi: 10.1016/s0005-8165(75)80034-5. [DOI] [PubMed] [Google Scholar]
  13. Hirohata T., Kuratsune M. The geographical comparison of mortality from cancer of the stomach and ulcer of the stomach in Japan. Br J Cancer. 1969 Sep;23(3):465–479. doi: 10.1038/bjc.1969.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hureau J., Delavierre P., Vayre P., Levasseur J. C., Bourdais J. P., Laburthe-Tolra Y. Association de la gastrite géante hypertrophique avec le cancer d'estomach et avec la polypose gastrique. Sem Hop. 1973 Jun 14;49(28):2042–2046. [PubMed] [Google Scholar]
  15. Imai T., Kubo T., Watanabe H. Chronic gastritis in Japanese with reference to high incidence of gastric carcinoma. J Natl Cancer Inst. 1971 Jul;47(1):179–195. [PubMed] [Google Scholar]
  16. JARVI O., LAUREN P. On the role of heterotopias of the intestinal epithelium in the pathogenesis of gastric cancer. Acta Pathol Microbiol Scand. 1951;29(1):26–44. [PubMed] [Google Scholar]
  17. JØRGENSEN J. The mortality among patients with pernicious anemia in Denmark and the incidence of gastric carcinoma among the same. Acta Med Scand. 1951;139(6):472–481. doi: 10.1111/j.0954-6820.1951.tb17184.x. [DOI] [PubMed] [Google Scholar]
  18. MAGNUS H. A. A re-assessment of the gastric lesion in pernicious anaemia. J Clin Pathol. 1958 Jul;11(4):289–295. doi: 10.1136/jcp.11.4.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. MATZNER M. J., RAAB A. P., SPEAR P. W. Benign giant gastric rugae complicated by submucosal gastric carcinoma; report of case. Gastroenterology. 1951 Jun;18(2):296–302. [PubMed] [Google Scholar]
  20. MING S. C., GOLDMAN H. GASTRIC POLYPS; A HISTOGENETIC CLASSIFICATION AND ITS RELATION TO CARCINOMA. Cancer. 1965 Jun;18:721–726. doi: 10.1002/1097-0142(196506)18:6<721::aid-cncr2820180609>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  21. MORSON B. C. Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. Br J Cancer. 1955 Sep;9(3):377–385. doi: 10.1038/bjc.1955.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. MORSON B. C. Precancerous lesions of upper gastrointestinal tract. JAMA. 1962 Feb 3;179:311–315. doi: 10.1001/jama.1962.03050050001001. [DOI] [PubMed] [Google Scholar]
  23. MOSBECH J., VIDEBAEK A. Mortality from and risk of gastric carcinoma among patients with pernicious anaemia. Br Med J. 1950 Aug 12;2(4675):390–394. doi: 10.1136/bmj.2.4675.390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Ming S. C. Dysplasia of gastric epithelium. Front Gastrointest Res. 1979;4:164–172. doi: 10.1159/000402298. [DOI] [PubMed] [Google Scholar]
  25. Nakamura K., Sugano H., Takagi K., Fuchigami A. Histopathological study on early carcinoma of the stomach: some considerations on the ulcer-cancer by analysis of 144 foci of the superficial spreading carcinomas. Gan. 1967 Aug;58(4):377–387. [PubMed] [Google Scholar]
  26. Nakamura T. Pathohistologische Einteilung der Magenpolypen mit spezifischer Betrachtung ihrer malignen Entartung. Chirurg. 1970 Mar;41(3):122–130. [PubMed] [Google Scholar]
  27. Nicholls J. C. Carcinoma of the stomach following partial gastrectomy for benign gastroduodenal lesions. Br J Surg. 1974 Mar;61(3):244–249. doi: 10.1002/bjs.1800610319. [DOI] [PubMed] [Google Scholar]
  28. Oehlert W., Keller P., Henke M., Strauch M. Die dysplasaien der Magenschleimhaut. das Problem ihrer klinischen Bedeutung. Dtsch Med Wochenschr. 1975 Sep 26;100(39):1950–1956. doi: 10.1055/s-0028-1106484. [DOI] [PubMed] [Google Scholar]
  29. PEAR E. G., HORSCH R. HYPERTROPHIC GASTRITIS WITH MALIGNANT DETERIORATION AND METASTASIS TO BONE. Am J Gastroenterol. 1964 Sep;42:280–284. [PubMed] [Google Scholar]
  30. Roux M., Vayre P., Levasseur J. C. Gastrite hypertrophique et épithélioma prépylorique. Sem Hop. 1968 Jun 14;44(29):1935–1936. [PubMed] [Google Scholar]
  31. Rubin R. C., Fink H. Giant hypertrophy of the gastric mucosa associated with carcinoma of the stomach. Am J Gastroenterol. 1967 May;47(5):379–388. [PubMed] [Google Scholar]
  32. SCHELL R. F., DOCKERTY M. B., COMFORT M. W. Carcinoma of the stomach associated with pernicious anemia; a clinical and pathologic study. Surg Gynecol Obstet. 1954 Jun;98(6):710–720. [PubMed] [Google Scholar]
  33. SWYNNERTON B. F., TRUELOVE S. C. Simple gastric ulcer and carcinoma. Br Med J. 1951 Nov 24;2(4742):1243–1246. doi: 10.1136/bmj.2.4742.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Sarrazin A., Simon J., Bousquet O., Paillas J., Monod-Broca P. Un cas de mnaladie de Ménétrier avec tumeur carcinoide microscopique de l'estomac. Arch Fr Mal App Dig. 1971 Jun-Jul;60(6):331–336. [PubMed] [Google Scholar]
  35. Schrumpf E., Serck-Hanssen A., Stadaas J., Aune S., Myren J., Osnes M. Mucosal changes in the gastric stump 20-25 years after partial gastrectomy. Lancet. 1977 Sep 3;2(8036):467–469. doi: 10.1016/s0140-6736(77)91599-9. [DOI] [PubMed] [Google Scholar]
  36. Siurala M., Varis K., Wiljasalo M. Studies of patients with atrophic gastritis: a 10-15-year follow-up. Scand J Gastroenterol. 1966;1(1):40–48. doi: 10.1080/00365521.1966.11800612. [DOI] [PubMed] [Google Scholar]
  37. Stamatakis J. D. Menetrier's disease and carcinoma of stomach. Proc R Soc Med. 1976 Apr;69(4):264–265. [PMC free article] [PubMed] [Google Scholar]
  38. TEXTER E. C., Jr, LEGERTON C. W., Jr, REEVES R. J., SMITH A. G., RUFFIN J. M. Coexistent carcinoma of the stomach and hypertrophic gastritis; report of a case with review of the literature. Gastroenterology. 1953 Aug;24(4):579–586. [PubMed] [Google Scholar]
  39. Valencia-Parparcen J., Celli B. Hypertrophic gastritis versus gastric carcinoma. Am J Gastroenterol. 1973 Feb;59(2):119–133. [PubMed] [Google Scholar]
  40. ZAMCHECK N., GRABLE E., LEY A., NORMAN L. Occurrence of gastric cancer among patients with pernicious anemia at the Boston City Hospital. N Engl J Med. 1955 Jun 30;252(26):1103–1110. doi: 10.1056/NEJM195506302522601. [DOI] [PubMed] [Google Scholar]

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