Understanding cellular changes, diagnostic predictors, and modern management strategies for gastric health.
Imagine a microscopic universe inside our body where billions of cells live by strict rules, performing their functions. But sometimes, under the influence of external factors, some begin to lose their specialization, initiating a process doctors call dysplasia 7 .
Dysplasia is a medical term derived from the Greek words "dys" (impairment) and "plasis" (formation), accurately reflecting the process: impairment of normal cell development 7 .
In dysplasia, cells lose their normal shape, size, and layer architecture, but unlike cancer, these changes do not penetrate the underlying tissues 6 .
Lower third of epithelium affected
1/3 to 2/3 of epithelial thickness affected
More than 2/3 of epithelial thickness affected
Endoscopic predictors are visual signs that help doctors suspect dysplasia before obtaining histology results:
Noted in 56% of patients with dysplasia 4
Detected in 90.2% of patients, with spontaneous bleeding in 14.6% of cases 4
Identified with chromoscopy 4
Considered a precancerous change 4
The study aimed to improve the informativeness of dysplasia diagnosis by combining white light endoscopy with chromoscopy, supplemented by targeted brush biopsy with cytological examination 4 .
Standard examination of upper GI tract
With 0.5% methylene blue
Cell collection from various gastric regions
Analysis of brush preparations
| Erosions | 90.2% |
| Spontaneous bleeding | 14.6% |
| Atrophic gastritis signs | 56% |
| Intestinal-type epithelium | 61% |
| Proliferation with mild dysplasia | 100% |
| Intestinal metaplasia | 65.8% |
| H. pylori confirmed | 92.6% |
The integration of chromoscopy and brush biopsy into routine endoscopic practice significantly increases the informativeness of the study and contributes to the early detection of precancerous mucosal lesions 4 .
Modern diagnosis of gastric dysplasia requires not only professional skills but also specialized equipment and reagents.
| Tool/Reagent | Purpose | Application Features |
|---|---|---|
|
Video Endoscope with Magnification
|
Visual examination of gastric mucosa | Allows detailed examination of epithelial structure, identification of atrophy areas, erosions |
|
0.5% Methylene Blue Solution
|
Chromoscopy - mucosal staining | Accumulates in areas of intestinal metaplasia, facilitating their identification |
|
Nylon Brush for Brush Biopsy
|
Collection of cellular material | Provides cell collection from large areas, including hard-to-reach areas |
|
Cytological Media and Dyes
|
Preparation and staining of preparations for microscopy | Allows visualization of cellular structures, assessment of atypia presence |
|
PCR Diagnostic Kits for H. pylori
|
Confirmation of infection | Detection of bacteria with high accuracy, strain determination |
Detection of mild dysplasia requires a balanced approach to patient management. Unlike more severe degrees of dysplasia that require active surgical intervention, mild dysplasia in most cases warrants a watchful waiting strategy 8 .
Elimination of the main cause of chronic inflammation promoting dysplasia progression. Studies confirm H. pylori in 92.6% of patients with dysplasia 4 .
Regular control endoscopic studies with cytological control. Cytological examination every 6 months for 18-24 months for early detection of possible recurrence 8 .
Smoking cessation, dietary normalization, alcohol restriction.
Treatment of concomitant GI tract pathology that may maintain the inflammatory process.
According to current guidelines, any drug treatment with suppositories, antibiotics, or immune stimulation drugs without clear indications is unfounded and should not be used 8 .
Mild dysplasia is not a verdict but rather a signal prompting more careful attention to digestive system health. Modern endoscopic methods, especially the combination of chromoscopy with targeted brush biopsy, open new possibilities for early detection of precancerous conditions.
The integration of these methods into routine clinical practice is a promising direction in gastroenterology, capable of significantly reducing the risk of gastric cancer development. As research shows, it is the comprehensive approach to diagnosis that combines various methodologies that provides the most accurate results.
References will be added here manually in the future.