Morphological characteristics of dysplasia in the mucous membrane adjacent to the tumor in intestinal type gastric cancer

Abstract

Introduction. Despite a significant number of publications and a concept known as Correa’s cascade, dysplas-tic processes and the mechanisms of gastric carcinogenesis, are still far from being completely understood. Dysplasia and the processes in the mucous membrane adjacent to the tumor node, their significance, and their role in the field cancerization have also been studied insufficiently. The aim of this work was to analyze the frequency of occurrence and some characteristics of high- and low-grade dysplasia in the gastric mucosa at variable distances from the tumor node. Materials and methods. We carried out a prospective histological study of surgical specimens from 49 patients with intestinal type gastric adenocarcinoma. We studied tissues from the tumor node and adjacent gastric mucosa at various distances from the tumor and assessed the frequency of occurrence and some characteristics of low- and high-grade dysplasia. Results. In the mucous membrane adjacent to the intestinal type adenocarcinoma, 73.5% of cases demon-strated low- and high-grade dysplasia. In all cases, background and precancerous processes were found in areas adjacent to the tumor node with low- and high-grade dysplasia. Conclusion. The incidence of low- and high-grade dysplasia detected in the mucous membrane adjacent to intestinal type gastric adenocarcinoma significantly decreases as the distance from the tumor node in-creases. Dysplastic changes are associated with epithelial hyperplasia, intestinal metaplasia, and inflamma-tory and atrophic changes. The results obtained support field cancerization and highlight the need to study morphological, molecular, and genetic alterations in the gastric mucosa adjacent to the tumor more deeply. The dysplastic changes present at the resection line area indicate that this fact must be considered when determining the resection line. Keywords: gastric cancer, low-grade dysplasia, high-grade dysplasia, epithelial dysplasia, intestinal meta-plasia, inflammatory infiltration, atrophy