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Precancerous states of the GI tract: Difference between revisions
Precancerous states of the GI tract (view source)
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== Colonic polyps == | == Colonic polyps == | ||
Several [[colonic polyps]], especially adenomatous polyps, are precancerous. | Several [[colonic polyps]], especially adenomatous polyps, are precancerous.<section begin="Barret oesophagus" /> | ||
== Barrett oesophagus == | == Barrett oesophagus == | ||
Barrett oesophagus is a consequence of chronic [[Gastroesophageal reflux disease|GERD]] where the chronic acid exposure of the oesophageal mucosa causes intestinal metaplasia (Barrett metaplasia). On histology goblet cells can be seen in the mucosa. It occurs in up to 15% of patients with GERD. | Barrett oesophagus is a consequence of chronic [[Gastroesophageal reflux disease|GERD]] where the chronic acid exposure of the oesophageal mucosa causes intestinal metaplasia (Barrett metaplasia). On histology goblet cells can be seen in the mucosa. It occurs in up to 15% of patients with GERD. | ||
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All patients with Barrett oesophagus should be on [[PPI]]. | All patients with Barrett oesophagus should be on [[PPI]]. | ||
Barrett oesophagus with high-grade dysplasia is treated with mucosectomy (endoscopic resection) or endoscopic ablation, same as T1A oesophageal cancer. No dysplasia or low-grade dysplasia may be managed either with regular surveillance or endoscopic removal.<section begin="leukoplakia and erythroplakia" /> | Barrett oesophagus with high-grade dysplasia is treated with mucosectomy (endoscopic resection) or endoscopic ablation, same as T1A oesophageal cancer. No dysplasia or low-grade dysplasia may be managed either with regular surveillance or endoscopic removal.<section end="Barret oesophagus" /><section begin="leukoplakia and erythroplakia" /> | ||
== Oral leukoplakia and erythroplakia == | == Oral leukoplakia and erythroplakia == | ||
Leukoplakia is an unbrushable white lesion, while the erythoplakias are fiery red. They are associated with increased risk of cancer and have normally no symptoms. The risk factors for leuko- and erythroplakias are [[smoking]], chewing tobacco and excessive [[alcohol]] intake. | Leukoplakia is an unbrushable white lesion, while the erythoplakias are fiery red. They are associated with increased risk of cancer and have normally no symptoms. The risk factors for leuko- and erythroplakias are [[smoking]], chewing tobacco and excessive [[alcohol]] intake. | ||