What are the precancerous diseases of gastric cancer?

Precancerous diseases of gastric cancer, that is, benign stomach diseases that can gradually evolve into gastric cancer, are mainly the following in clinical practice.

Gastric ulcer: There are different opinions on the canceration of gastric ulcer in clinical practice. Most people believe that canceration may occur, but the probability of canceration is not high, about less than 1%.

Chronic gastritis : Chronic atrophic gastritis can develop into gastric cancer, with a canceration rate of 0% to 10%, and about 2% in China. Factors associated with atrophic gastritis and canceration may include:

① The canceration rate of antral gastritis can be as high as 10%, which is higher than that of gastric body gastritis;

② Intestinal metaplasia: The canceration rate of chronic gastritis patients with intestinal glandular metaplasia is 4 times higher than that of patients without intestinal metaplasia;

③ Dysplasia. Severe dysplasia can evolve into gastric cancer.

Gastric polyps: Of the two histological types of gastric polyps, adenomatous polyps can develop into adenocarcinomas, while hyperplastic polyps have a lower chance of becoming cancerous.

Remnant stomach: With the widespread implementation of partial gastrectomy, the incidence of remnant stomach cancer has gradually increased, especially in patients who have undergone Billroth-Ⅱ surgery. The remnant stomach after partial gastrectomy can become cancerous, but it usually takes more than 10 years. The reasons for this may be: bile and pancreatic juice reflux, causing atrophic gastritis in the remnant stomach, reduced gastric acid, leading to abnormal bacterial growth in the stomach, and ultimately converting secondary amines or nitrites into nitrosamines, leading to cancer.