Glandular low-grade intraepithelial neoplasia

Neoplasia is a long process and will not spread throughout the body all at once. If you feel discomfort in other parts of the body, you should consider whether there is a tumor. Pay more attention to rest and avoid overwork. Regular check-ups should be performed to rule out other diseases and the possibility of tumors. Tumors can be divided into benign and malignant. Generally, benign tumors are of no concern, but malignant tumors require immediate action. Pay more attention to your diet and eat more nutritious food.

There is a transition stage from normal tissue to cancer. Intraepithelial neoplasia belongs to this stage, but it is only one step away from real cancer. It is a precancerous lesion.

Glandular low-grade intraepithelial neoplasia is mainly mild to moderate atypical hyperplasia, which is a precancerous lesion. If it is not treated in time, it can develop into cancer over a long period of time. It is recommended to actively and standardizedly treat it under the guidance of a doctor, have regular check-ups, avoid eating spicy and irritating foods, eat more vegetables and fruits, pay attention to personal hygiene, and change underwear frequently.

Low-grade intraepithelial neoplasia. The low grade is equivalent to mild to moderate atypical hyperplasia, and the high grade is equivalent to severe atypical hyperplasia or dysplasia or low-grade epithelial intraepithelial neoplasia of carcinoma in situ. Sometimes it is related to inflammatory stimulation, and sometimes it may be a benign lesion itself. We can only say that it may be related to this. There is no way to determine whether it is caused by this. Because this situation has occurred, there is no way to know how it came about. Now all we have to do is to have regular check-ups.

For a long time, there has been a great disagreement between Japanese and European and American scholars on the issue of dysplasia and whether it has become cancerous. Japanese scholars argue that cancer can be determined based on the degree of glandular atypia, while European and American scholars argue that clear evidence of infiltration is necessary to determine whether a cancer is cancer. Although the WHO tumor classification published in 2000 clearly divides gastric mucosal precancerous lesions into low-grade and high-grade intraepithelial neoplasia according to the degree of cellular atypia and structural disorder, there are still inconsistencies in diagnosis during implementation.

Therefore, relevant experts held two international conferences to specifically discuss the classification and diagnostic criteria of gastric intraepithelial neoplasia and early cancer. Finally, at the second Vienna International Conference, a relatively consistent opinion was reached, that is, the series of changes of gastric mucosa from reactive hyperplasia to invasive cancer were divided into five categories: reactive hyperplasia, uncertain intraepithelial neoplasia (i.e., it is difficult to distinguish whether it is reactive hyperplasia or dysplasia), low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia and invasive cancer. Among them, the nature of low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia are both non-invasive cancers. Severe dysplasia, carcinoma in situ and even suspected invasive cancer, which were most prone to disagreement in diagnosis in the past, are clearly classified as high-grade intraepithelial neoplasia, collectively referred to as high-grade intraepithelial neoplasia.

Based on this classification principle, the participants diagnosed a group of gastric mucosa separately, and the consistency rate reached more than 90% (190,221 cases), which is much higher than the previous consistency rate (30% to 40%). While formulating the pathological diagnosis classification standards, the participants also put forward principled treatment recommendations for different lesions based on the fact that the probability of low-grade and high-grade intraepithelial neoplasia developing into invasive cancer in a large amount of follow-up data is 0% to 15% and 25% to 85%, respectively. That is, low-grade patients should be followed up and endoscopic resection should be performed when necessary; for patients with high-grade intraepithelial neoplasia, endoscopic resection or surgical resection should be determined in combination with endoscopic findings. This classification better addresses the feasibility, repeatability and clinical relevance of the diagnostic criteria and should be accepted by pathologists and clinicians.