부산대학교 도서관

Stomach cancer is frequently preceded by the appearance of atrophic gastritis (inflammation of the stomach with atrophy of the cells lining the organ) and intestinal metaplasia (conversion of intestinal cells to other cell types). These latter two conditions, which are considered to be precancerous lesions, frequently appear concomitantly with pernicious anemia (a condition characterized by a decrease in the number of red blood cells and a drastic reduction in gastric acid secretion). Hence, pernicious anemia is sometimes taken as a harbinger of stomach cancer. To investigate the development of gastrointestinal abnormalities in patients diagnosed with pernicious anemia, a study was carried out with 80 patients suffering from this disorder who underwent endoscopy (viewing the inner surface of the stomach with a fiber optic device). One patient underwent total gastrectomy (surgical removal of the stomach) for gastric cancer shortly after the endoscopic procedure. Twelve additional patients were closely watched and underwent follow-up endoscopy 14 months later. Two of these patients displayed cancer-like growths. The remaining 67 patients were followed-up six to seven years after the initial screening. At this follow-up, eight of these patients had died; two of unknown causes, and six of causes unrelated to the anemia or gastrointestinal disease. In 38 patients, endoscopy was not repeated, but there was no evidence of progression towards gastric cancer. Twenty-seven patients in whom repeat endoscopy was performed showed no change in the status of the gastrointestinal tract. Based on these findings, it is recommended that patients with pernicious anemia undergo endoscopic evaluation as soon as possible after diagnosis; patients with severe mucosal dysplasia or polyps should be re-examined regularly; and follow-up endoscopies should be performed at five-year intervals is sufficient for most patients. (Consumer Summary produced by Reliance Medical Information, Inc.)