Clinical Management of Gastric Adenoma, From the Point of View of Endoscopic Surveillance Noriaki Hasuike 1 , Ichiro Oda 1 , Takuji Gotoda 1 , Hisanao Hamanaka 1 , Hajime Yamaguchi 1 1Endoscopy Division, National Cancer Center Hospital Keyword: 胃腺腫 , 高危険群 , 治療方針 , 経過観察 , EMR pp.1419-1426
Published Date 2003/9/25
DOI https://doi.org/10.11477/mf.1403100759
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 Treatment strategies for gastric adenoma have been widely discussed, but it is still difficult to decide when to initiate the treatment.

 We analyzed 177 lesions in 150 cases with gastric adenoma diagnosed by specimen biopsy at the National Cancer Center Hospital, from 1997 to 2001. All cases were followed-up for more than one year. Among 177 adenomas, 30 lesions (17%) were developed adenocarcinomas, 28 lesions were treated by endoscopic mucosal resection or gastrectomy. All lesions except one case were intramucosal, well-differentiated adenocarcinomas with low-grade atypia. Almost all the lesions (89%) had adenoma-like components that corresponded to their histological findings at first biopsies. Among all the adenomas, the high-risk group for developing adenocarcinoma was characterized by the following endoscopic findings : a. size lager than 2 cm and b. a depressed type lesion.

 In conclusion, we recommend endoscopic surveillance in gastric adenoma except in the high-risk group. In cases of adenocarcinoma originating from adenoma, the lesions can be cured by EMR.

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