Is it serious to have a gastric biopsy?

Gastric biopsy is performed through gastroscopy, also called upper gastrointestinal endoscopy, which is performed through a fiber optic microcatheter wrapped in black plastic. Many people always feel that they have a serious disease after doing gastroscopy. In fact, this is not necessarily the case. When doing a gastroscopy on the stomach, some serious diseases should be ruled out first, and the specific causes should be understood before symptomatic treatment can be given.

Is a gastric biopsy serious?

That's not necessarily the case. Many patients undergo gastroscopy and biopsy due to upper abdominal discomfort. As for the pathological diagnosis report of gastroscopy and biopsy, some patients do not take it seriously and do not even think about it, thinking it is not important; while those with severe symptoms are overly nervous and seem confused and at a loss. How to correctly interpret the pathological diagnosis report of gastroscopy biopsy? Here is a brief description of some common diagnostic terms.

1. Superficial gastritis:

It refers to the infiltration of inflammatory cells, mainly lymphocytes or plasma cells, in the superficial layer of gastric mucosa, while the glands in the deep layer are normal. According to the degree of inflammatory cell infiltration, superficial gastritis can be divided into mild, moderate and severe. If accompanied by neutrophil infiltration, there is acute inflammation.

2. Atrophic gastritis:

It means that in addition to inflammatory cell infiltration of the mucosa, partial or complete disappearance of the gastric glands can also be seen. Depending on the degree of glandular reduction, atrophic gastritis can be divided into mild, moderate and severe. Atrophic gastritis must be treated aggressively because it is prone to intestinal metaplasia.

3. Lymphoid follicles:

It refers to a reactive hyperplasia of lymphoid tissue caused by long-term chronic inflammation of the gastric mucosa. Under normal circumstances, there is no lymphoid tissue in the gastric mucosa. Repeated proliferation of lymphoid tissue can develop into lymphoma, so the presence of lymphoid follicles in gastric mucosal biopsy, especially in middle-aged and elderly people, should attract the attention of clinical physicians.

4. Intestinal metaplasia:

Intestinal metaplasia, also known as intestinal metaplasia, refers to a pathological change in which the gastric mucosal epithelium is transformed into intestinal mucosal epithelium under long-term repeated stimulation of chronic inflammation and various harmful factors. Intestinal metaplasia is a compensatory response of the body to various harmful stimuli. Chronic atrophic gastritis is often accompanied by intestinal metaplasia. Current studies suggest that there is a certain correlation between intestinal metaplasia and the occurrence of gastric cancer. Therefore, patients who show intestinal metaplasia during endoscopic biopsy should be taken seriously and treated early.

5. Atypical hyperplasia of gastric mucosa:

That is, dysplasia, which is a more serious pathological change than intestinal metaplasia. It can develop directly from chronic atrophic gastritis or through intestinal metaplasia. It is now clear that atypical hyperplasia is a precancerous lesion, so it should be taken seriously. The new WHO classification calls atypical hyperplasia intraepithelial neoplasia, with mild and moderate atypical hyperplasia classified as low-grade intraepithelial neoplasia and severe atypical hyperplasia classified as high-grade intraepithelial neoplasia. Mild atypical hyperplasia should be reviewed by gastroscopy every 3-4 months, moderate atypical hyperplasia should be reviewed every 2-3 months, and severe atypical hyperplasia should be treated with surgery as soon as possible.

6. Cancer:

If the report directly reports cancer, it is a definite diagnosis. Some patients or their families will ask when they get the report whether the cancer is in the early, middle or late stage. Endoscopic biopsy can only determine the nature of the lesion. Tumor staging must wait until the gross specimens are surgically removed for sufficient sampling, preparation and microscopic observation, and then a comprehensive assessment is made by judging the depth of cancer tissue infiltration, degree of differentiation, and lymph node metastasis.