[An evaluation of the clinical significance of gastric dysplasia: a histological follow-up study]. / Evaluación del significado clínico de la displasia gástrica: estudio de seguimiento histológico.

ABSTRACT

To evaluate the clinical and prognostic significance of gastric dysplasia, we have carried out a study on 59 patients with histologic data obtained in a sequential way. The initial diagnosis was mild dysplasia in 24 patients, moderate in 18 cases and severe in 17 cases. The length of the follow up varied from one month to 13 years. The results suggest that, whereas cases of mild and moderate intensity tend to stability or regression, severe dysplasia is a reliable marker of high risk of gastric cancer. However, in our series as well as in the experience of others, the time elapsed between the diagnosis of severe dysplasia and the development of gastric carcinoma is usually very short. Because of this, we conclude that a carcinoma was probably already present when the initial biopsy was made. This conclusion emphasizes its diagnostic rather than its prognostic value in most occasions. Of 12 cases in our series which evolved to gastric carcinoma, 4 were diagnosed in an early stage (intramucosal). This fact confirms the importance of the recognition of gastric dysplasia for the early detection and control of these patients.