Patients with gastric dysplasia at risk of progression to gastric adenocarcinoma
Gastric dysplasia (GD), specifically high-grade lesions, appears to carry an elevated risk of progression to gastric adenocarcinoma (GAC), according to the results of a meta-analysis.
Researchers searched multiple online databases for studies reporting the incidence rate of GAC among patients with GD. They used Cochran Q and I tests to evaluate heterogeneities between included studies.
Of the 1,980 records retrieved, 30 articles (61 studies) were included in the meta-analysis. Data were pooled using random-effect or fixed-effect models.
The overall pooled incidence rate of GAC in patients with GD was 40.36 (95 percent CI, 27.08–55.71; I2, 96.0 percent) cases per 1,000 person-years. Subgroup analysis defined according to the type of GD revealed the highest GAC incidence among patients with high-grade dysplasia (HGD) lesions (186.40 per 1,000 person-years, 106.63–285.60; I2, 94.6 percent). Among low-grade dysplasia (LGD) and nonclassified lesions, the corresponding incidence rates were 11.25 (3.91–21.22; I2, 89.3 percent) and 1.40 (0.00–9.71; I, 78.8 percent) per 1,000 person-years.
Of note, patients with HGD were about 16 times as likely as those with LGD lesions to progress from GD to GAC.
The current findings highlight the importance of strict management of HGD lesions to prevent GAC, as the majority of patients with GAC are diagnosed in an advanced stage, the researchers said.