Two precancerous conditions of gastric cancer

The precancerous state of gastric cancer is divided into precancerous diseases and precancerous lesions. The former refers to benign gastric diseases related to gastric cancer, which have the risk of developing gastric cancer, while the latter refers to pathological changes that are easily transformed into cancerous tissue.

1. Precancerous diseases

There are four main types of precancerous diseases of gastric cancer: ① Chronic atrophic gastritis: The gastric mucosa of patients with chronic atrophic gastritis undergoes atrophic changes, often accompanied by intestinal metaplasia, and is prone to canceration; ② Gastric polyps: Inflammatory gastric polyps account for about 80%, and their diameter is mostly less than 2 cm. The canceration rate is relatively low, while adenomatous polyps with a diameter of more than 2 cm have a higher canceration rate; ③ Gastric ulcer: Gastric ulcer canceration often starts from the edge of the ulcer, and is related to inflammation, erosion, regeneration and dysplasia of the ulcer edge; ④ Remnant gastritis: Patients who undergo gastrectomy for various reasons, especially those who undergo Billroth II surgery, are prone to canceration, with a latent period of 10 to 15 years.

2. Precancerous lesions

There are two types of precancerous lesions of gastric cancer: ① Intestinal metaplasia: There are two types of intestinal metaplasia, namely small intestinal type and large intestinal type. The latter is also called incomplete intestinal metaplasia. The intestinal metaplasia cells do not contain leucine aminopeptidase and alkaline phosphatase, which leads to the accumulation of carcinogens in the cells and eventually dysplasia and cancer; ② Dysplasia: The glandular duct structure and epithelial cells of the gastric mucosa lose their normal state and undergo hemorrhagic atypical changes. The histology is between benign and malignant, and we should be highly vigilant.