Résumé
Dans une série de 3 900 patients soumis à une gastroscopie, la fréquence totale de la dysplasie classée selon les différents degrés, a fait l’objet d’une étude rétrospective.
66 patients présentant des signes histologiques de dysplasie épithéliale ont été inclus dans une étude de surveillance systématique, et une attention particulière a été accordée à l’association entre cette anomalie et la gastrite chronique atrophique (G.C.A.).
Les résultats de l’étude montrent que les lésions de dysplasie légère sont fréquentes alors que les lésions de dysplasie modérée et sévère sont plus rares. La dysplasie, en particulier celle de degré de sévérité élevé, est associée à la gastrite chronique atrophique (G.C.A.).
Ce fait semble influencer l’évolution au cours du temps et la majorité des cas de dysplasie associée à une G.C.A. ont connu une évolution progressive et dans 4 cas, furent associés à un cancer gastrique.
Les lésions histologiques de dysplasie à haut degré de sévérité doivent être évaluées avec soin, en particulier lors d’une association avec une G.C.A., vu leur caractère de lésion à haut risque ou leur association avec un cancer de l’estomac.
Summary
The overall incidence of mild, moderate or severe gastric epithelial dysplasia in an endoscopic series was retrospectively evaluated.
66 patients presenting dysplastic mucosal changes were included in a follow-up study, and particular attention was focused on the association of chronic atrophic gastritis (C.A.G) to epithelial dysplasia in affecting the evolution in time of this precancerous lesion.
The result of the study show that mild dysplastic changes are a frequent finding while moderate or severe dysplasia is less frequently documented. Dysplasia, particularly in its higher degree, associates with the presence of C.A.G. This, in turn, seems to affect the evolution in time of the lesion, since almost only the cases of epithelial dysplasia associated to C.A.G. show a progression and the four cases of gastric cancer in this study fell within this group.
Histological findings of high grade dysplasia must be carefully evaluated, particularly when associated to C.A.G., because of their relatively high risk of evolution to or association with gastric cancer.
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Cardin, F., Farinati, F., Di Mario, F. et al. Dysplasie é pithé liale gastrique: ré sultats du dé pistage et d’ une surveillance systé matique. Acta Endosc 16, 175–183 (1986). https://doi.org/10.1007/BF02962895
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DOI: https://doi.org/10.1007/BF02962895