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Faut-il surveiller la métaplasie intestinale et la dysplasie dans l’estomac ?

Is it necessary to monitor intestinal metaplasia and dysplasia in the stomach?

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Acta Endoscopica

Résumé

La majorité des cancers gastriques est issue de lésions prénéoplasiques qui apparaissent plusieurs années auparavant. Ces lésions sont l’atrophie et la métaplasie intestinale de la muqueuse gastrique induites par une infection ancienne par Helicobacter pylori. L’atrophie sur le corps gastrique associée à la métaplasie intestinale est un facteur de risque particulier de cancer. Il existe un effet bénéfique de l’éradication de H. pylori sur l’évolution des lésions prénéoplasiques n’ayant pas atteint le stade de métaplasie intestinale. Une surveillance tous les trois ans a été recommandée particulièrement chez les patients ayant des lésions étendues dans le corps gastrique et l’antre ou sévères quelle que soit la localisation. En cas de dysplasie de bas grade découverte sur des biopsies étagées, une surveillance annuelle est préconisée.

Abstract

The majority of stomach cancers are the result of preneoplastic lesions that have appeared several years previously. This damage is in the form of atrophy and intestinal metaplasia of the gastric mucosa caused by a prior infection due to Helicobacter pylori. Atrophy to the body of the stomach associated with intestinal metaplasia is an identified cancer risk factor. There is a beneficial effect of eradicating H. pylori seen in the evolution of this preneoplastic damage that has yet to reach the intestinal metaplasia stage. A follow-up every three years is recommended, especially for patients who have extensive or severe damage to the body of the stomach and pyloric antrum, regardless of the localisation. In cases of low grade dysplasia discovered at staging biopsies, annual follow-ups are recommended.

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Correspondence to D. Lamarque.

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Lamarque, D. Faut-il surveiller la métaplasie intestinale et la dysplasie dans l’estomac ?. Acta Endosc 42, 257–260 (2012). https://doi.org/10.1007/s10190-012-0281-1

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