Why should we emphasize the diagnosis and treatment of precancerous lesions?
In outpatient clinics, we often hear patients say, “I am not afraid of anything, but I am afraid of getting cancer.” Indeed, everyone’s common sense knows that although modern medicine has developed a lot, for tumors, doctors and patients often face a situation of helplessness.
Tumors do not occur overnight and arise all at once, but often have to go through the stage of precancerous lesions before slowly developing into cancer.
Therefore, special emphasis should be placed on early diagnosis and treatment of tumors in order to nip them in the bud.
What is precancerous lesion?
It is not yet at the level of cancer, but if not treated in time, it may develop into cancer in the future after a period of time. There is no clear answer as to how long it will change and what percentage will change.
When should I suspect that I may have a problem in this area? Unfortunately, there is no characteristic symptom which can let the doctor know that the patient has precancerous lesions at a glance. There may be some risk factors, such as family history, first-degree relatives of tumor patients (parents, siblings, children) will have a higher relative risk; older people will have a higher risk than younger people.
How can we find out and determine the presence or absence of it?
Gastroscopy + biopsy pathology is the only test that can determine it. Just like some technological tools can help the police to lock up criminals, modern gastroscopy techniques have come a long way, and with the help of special staining, magnification and other features, doctors can show the lesions that were not very clear very clearly
How can we know whether we have precancerous lesions from the gastroscopy report?
In the past, the diagnosis of “atypical hyperplasia” or “heterogeneous hyperplasia” was often used, but in recent years, most hospitals have adopted the diagnosis of “intraepithelial neoplasia” according to the uniform regulations of the World Health Organization (WHO). Intraepithelial neoplasia” is the diagnosis. Generally speaking, the presence of such a term often indicates the presence of a possible precancerous lesion.
Intraepithelial neoplasia can be divided into “low grade” and “high grade”, and some hospitals use “mild, moderate, or severe” to indicate the degree of the lesion, but in general, high grade or severe is more serious than low grade or mild. In general, high-grade or severe lesions are more serious than low-grade or mild lesions, and have a higher chance of becoming cancerous.
Since it is not cancerous, can it be treated by taking medicine?
In general, only a small number of precancerous lesions may reverse to normal cells, while most precancerous lesions, whether you take medicine or not, will always progress sooner or later.
As for the speed of development, it is often affected by many factors, such as genetics, physical condition, diet, H. pylori infection, etc. It is very complicated.
What should be done for precancerous lesions?
It depends on the specific situation
If the pathological diagnosis is “low-grade intraepithelial neoplasia”, there are two options: first, to review gastroscopy regularly, usually every 3-6 months, to see if the lesion continues to develop or remains unchanged; if it continues to develop, endoscopic resection or surgical resection will be performed; if it remains unchanged, observation will continue; second, to perform gastroscopic resection. of resection. Generally speaking, most of the patients we encounter will choose the second treatment method because gastroscopy every 3-6 months is not only painful for the patient, but more importantly, the patient will suffer a lot of psychological pressure.
If the pathological diagnosis is “high-grade intraepithelial neoplasia”, there are three options: first, regular gastroscopy; second, endoscopic resection; and third, surgical treatment.
The biggest advantage of endoscopic resection is that it is less invasive, faster recovery and less costly.
Regardless of whether it is endoscopic resection or surgical resection, does the cut specimen have to be tested?
Yes, this is very important! Therefore, after resection, the whole specimen should be sent to the pathology department for examination to see if there is cancer and if so, to which layer before deciding what to do next.
Will precancerous lesions recur after excision?
- As mentioned above, the reasons why people grow tumors are very complicated and not yet clear, people who already have precancerous lesions have a higher chance of recurrence than the general population, so we ask patients to have regular checkups after treatment.