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Korean J Helicobacter  Up Gastrointest Res > Volume 18(2); 2018 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2018;18(2):103-109.
DOI: https://doi.org/10.7704/kjhugr.2018.18.2.103    Published online June 10, 2018.
The Natural History and Treatment Strategy of Gastric Adenoma as a Pre-cancerous Lesion
Soo In Choi, Jun Chul Park 
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. JUNCHUL75@yuhs.ac
전암성 병변인 위선종의 자연 경과와 치료 전략
최수인, 박준철
연세대학교 의과대학 내과학교실
Correspondence:  Jun Chul Park, Tel: +82-2-2228-5201, Fax: +82-2-365-2125, 
Email: JUNCHUL75@yuhs.ac
Received: 8 February 2018   • Revised: 11 April 2018   • Accepted: 11 April 2018
Abstract
The concept and pathological diagnostic criteria of gastric adenoma (dysplasia) differ between Western countries and Japan, and discrepancies between histopathological examinations before and after endoscopic resection may occur. Therefore, the natural history of adenoma should be interpreted and the treatment strategy of adenoma established. It is recommended that endoscopic resection be performed for high-grade dysplasia due to the potential higher risk of progression to carcinoma. For low-grade dysplasia, the risk of malignant transformation is relatively low. However, resection is considered the first approach for the purpose of diagnosis and treatment. If resection is not feasible, the alternative may be to use argon plasma coagulation for selected lesions that are less likely to be malignant. When Helicobacter pylori infection is detected, eradication therapy is recommended to reduce the risk of metachronous lesions. Post-resection follow-up should be performed within 1 year to detect synchronous lesions and then follow-up endoscopy at 1 or 2-year intervals may be considered for metachronous lesions.
Key Words: Adenoma; Dysplasia; Natural history; Stomach; Treatment
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