| Abstract [eng] |
Introduction Gastric cancer is associated with a poor prognosis due to the late stage of the disease at the time of diagnosis. Consequently, the detection and surveillance of premalignant gastric lesions becomes imperative. Aims and methods This study aimed to assess a) the incidence of gastric cancer in patients with proven premalignant gastric lesions b) the efficacy of endoscopic diagnosis of premalignant gastric lesions and c) trends of subsequent management of patients at a high risk for the development of gastric cancer in the tertiary care centre in Lithuania. The pathology database was filtered for keywords “atrophy” and/or “intestinal metaplasia” to identify patients with possible premalignant gastric lesions. Demographic features, pathology reports, endoscopic evaluation, patient history and subsequent management data were collected. Results Of 1842 patients screened in the pathology database, 1762 had histologically proven premalignant gastric lesions. Histological evaluation revealed gastric atrophy in 9.9% (n = 183), distal atrophy in 6.1% (n = 113) and panatrophy in 3.8% (n = 70) of samples. Distal intestinal metaplasia was observed in 47.9% (n = 883), intestinal metaplasia was found in 47% (n = 866) of samples. Endoscopically precancerous lesions were identified in only 14.4% (n = 254) of cases, with follow-up recommendations provided for 3.4% (n = 60) of the patients. During follow-up 0.8% (n = 14) of patients with premalignant gastric lesions were diagnosed with gastric cancer. Conclusions This study shows very poor efficacy of endoscopic evaluation for precancerous gastric lesions and even worse adherence to current guidelines for their management. These findings underpin the importance of high-quality endoscopy and adherence to the guidelines in the hopes of reducing the morbidity and mortality of gastric cancer. |
