Atrophic gastritis dysplasia

Atrophic gastritis is the problem that worries people the most, because atrophic gastritis can cause the stomach and intestines to atrophy little by little, and eventually lead to cancer. This process is very scary, so we must pay more attention to it in normal times. However, when people are paying attention to atrophic gastritis, atrophic gastritis dysplasia may also occur. This is a big problem that requires special care and relevant preventive work.

What do patients with atrophic gastritis worry about most?

It's cancer. In fact, it is not necessary. First, only about 1% of atrophic gastritis actually turns into cancer. Second, the occurrence of cancer requires a process, and during this process we can do a lot to prevent and treat it. But even though I have been explaining it this way, some patients with atrophic gastritis still become very nervous and at a loss when they discover "atypical hyperplasia" of the gastric mucosa.

So what is "atypical hyperplasia"? This is a pathological concept. The main manifestation is that the epithelial cells undergo different changes and lose their normal tissue structure. In general, the atypical hyperplasia of chronic atrophic gastritis is often considered to be an intermediate process towards malignant transformation. In fact, many atypical hyperplasias are transient reparative hyperplasias caused by chronic inflammation and can disappear after treatment.

There are several types of "hyperplasia" in the tissue pathology caused by atrophic gastritis: atypical hyperplasia, dysplasia, and intraepithelial neoplasia. Many people think that the concepts are similar and are all "precancerous lesions." In fact, there are differences in the concepts seen by these pathologists. Atypical hyperplasia means that the morphology of epithelial cell proliferation is atypical; dysplasia mainly occurs on the basis of intestinal metaplasia, and some of it also occurs in the epithelium of gastric pits. According to the degree and range of differentiation of dysplasia, it is divided into three levels: mild, moderate and severe. Mild refers to inflammatory and regenerative benign dysplastic lesions; moderate refers to "critical lesions" with more obvious dysplasia, close to gastric cancer; severe refers to dysplasia with more obvious dysplasia, which is morphologically difficult to distinguish from differentiated cancer. Intraepithelial neoplasia can be seen as a synonym for dysplasia, but dysplasia focuses on morphological changes, while intraepithelial neoplasia emphasizes the process of tumor evolution. The spectrum of intraepithelial neoplasia is more extensive than that of dysplasia. Dysplasia is usually divided into three grades: mild, moderate, and severe. Intraepithelial neoplasia is divided into low-grade intraepithelial neoplasia, which refers to epithelial structural and cytological abnormalities limited to the lower half of the epithelium, equivalent to mild and moderate dysplasia. High-grade intraepithelial neoplasia refers to the extension of epithelial structural and cytological abnormalities to the upper half of the epithelium or even the entire layer, which is equivalent to severe dysplasia and carcinoma in situ.