Lauwers-Early gastric neoplasms

Despite a marked decline in incidence in the West and some decrease in the East, gastric cancer remains a significant cause of morbidity and cancer related deaths worldwide. The prevalence of gastric cancer is closely related to prevalence of Helicobacter pylori infection and shows wide geographic variation. Subsequent chronic gastritis, atrophy, and intestinal metaplasia are lesions that confer a high risk for the development of gastric cancer, while gastric dysplasia, the penultimate stage of the carcinogenetic cascade, is a direct neoplastic precursor lesion.2, 4, 14-16, 18, 22, 36, 41, 60, 64 Evidence for gastric dysplasia as a direct precursor of adenocarcinoma stems from observational studies reporting high-grade dysplasia (HGD) in close proximity to 40-100% of early gastric cancers and 5-80% of advanced adenocarcinomas.48, 61, 95 Moreover, dysplasia is also a marker of increased risk for cancer elsewhere in the gastric mucosa.