
Heterogeneity in esophageal and gastric cardia precursor progression during six‐year endoscopic surveillance after population‐based screening in a C hinese high‐risk region
Author(s) -
Wen Denggui,
Zhang Liwei,
Wang Xiaoling,
Wen Xiaoduo,
Yang Yi,
Chen Yuetong,
Wang Guiying,
Akazawa Kohei,
Wang Shijie,
Shan Baoen
Publication year - 2017
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12446
Subject(s) - medicine , dysplasia , gastroenterology , population , esophageal cancer , cancer , carcinoma , medical diagnosis , esophagus , pathology , environmental health
Background The study was conducted to examine esophageal and gastric cardia precursor progression. Methods After population‐based baseline screening, 145 precursor and 335 chronic inflammation cases were endoscopically surveyed for six years. Results Surveillance of interval and baseline diagnoses for 18 severe dysplasia ( SD ) cases later detected were: 13, 23, 39, and 44 months since a diagnosis of chronic inflammation in four cases; 6, 6, 6, 11, 13, 16, 16, and 23 months since mild dysplasia (m D ) diagnoses in eight; and 6, 9, 10, 13, 18, and 48 months since moderate dysplasia ( MD ) diagnoses in six. Rates for 11 carcinoma in situ ( C is) cases later detected were: 7 and 18 months since basal cell hyperplasia ( B ch) diagnoses in two; and 6, 6, 9, 13, 13, 18, 35, 44, and 50 months since MD diagnoses in nine. In 10 cancer cases later detected, rates were: 6, 6, 7, 18, 19, 34, 36, and 48 months since SD diagnoses in eight cases with submucosal carcinoma; 46 months since MD diagnosis in a T 2 N 0 M 0 carcinoma case; and 52 months since B ch diagnosis in another T 2 N 0 M 0 case. Conclusion Esophageal and gastric cardia precursors are heterogeneous. Male gender, advanced age, family history of upper gastrointestinal cancer, and multifocal dysplasia are significant independent predictors for progression, and B ch/m D , MD , and SD constitute three distinctive entities regarding the risk of cancer.