Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Apr 16, 2015; 7(4): 396-402
Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.396
Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.396
Optimal management of biopsy-proven low-grade gastric dysplasia
Jung-Wook Kim, Jae Young Jang, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-702, South Korea
Author contributions: Kim JW wrote the paper; Jang JY designed and edited the paper.
Conflict-of-interest: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jae Young Jang, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kyung Hee University, 1 Hoegi-dong Dongdaemun-gu, Seoul 130-702, South Korea. jyjang@khu.ac.kr
Telephone: +82-2-9588200 Fax: +82-2-9681848
Received: November 3, 2014
Peer-review started: November 4, 2014
First decision: November 27, 2014
Revised: December 22, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 16, 2015
Peer-review started: November 4, 2014
First decision: November 27, 2014
Revised: December 22, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 16, 2015
Core Tip
Core tip: According to the guideline, endoscopic resection or follow-up is recommended for noninvasive category 3 low-grade dysplasias (LGDs), while category 4 lesions such as high-grade dysplasia, non-invasive carcinoma and intramucosal carcinoma should be removed by local resection. However, as LGD has a relatively high underdiagnosis rate and rarely contains submucosal cancer, a follow-up strategy might result in the opportunity for endoscopic therapy being missed. Furthermore, repeated endoscopic examinations with biopsies might impose a psychological and financial burden on the patient. Based on its efficacy and safety, the use of endoscopic submucosal dissection as a primary procedure for LGD should be considered.