Abstract：
:Precursor lesions in the GIT include flat dysplasias, adenomas, dysplasia superimposed on nonneoplastic polyps, endocrine cell dysplasia, ACF, and condyloma accuminatum. Interobserver variability can be a problem in reporting dysplasia, and ancillary techniques including flow cytometry, image analysis, proliferation markers, and examination for p53 expression can help in this task. Squamous dysplasia seen in the esophagus and anus is graded on either a two-tiered or three-tiered system largely based on the extent of mucosal involvement. Glandular dysplasia is morphologically similar whether seen as an adenomatous polyp or within the setting of Barrett's esophagus, atrophic gastritis, or idiopathic inflammatory bowel disease. The distinction between LGD and HGD in glandular mucosa is based on the severity of cytologic and architectural distortion. Type I dysplasia is the classic adenomatous pattern seen most commonly and recognized by the presence of elongate hyperchromatic stratified nuclei. Type II, the nonadenomatous variant, contains vesicular nuclei and alteration in nuclear size and shape. Nonantral endocrine dysplasia in the stomach is seen in the setting of corporal predominant atrophic chronic gastritis and Zollinger-Ellison syndrome with Multiple Endocrine Neoplasia syndrome type I. Condyloma accuminatum is a HPV-related lesion most commonly seen in men practicing anal intercourse. Superimposed squamous dysplasia can be seen with HGD most frequently in the HIV-positive population. Recognition of the different classification systems of dysplasia, the most frequent settings in which these lesions are found, and their natural history is important for all practicing gastroenterologists and pathologists.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Haber MMdoi
10.1016/s0889-8553(02)00007-9subject
Has Abstractpub_date
2002-06-01 00:00:00pages
395-419issue
2eissn
0889-8553issn
1558-1942pii
S0889-8553(02)00007-9journal_volume
31pub_type
杂志文章,评审abstract：:Barrett's esophagus, currently defined as endoscopically apparent columnar metaplasia of the esophagus with histologic documentation of goblet cells, is the precursor to esophageal adenocarcinoma. However, not all patients with this disorder require intensive surveillance. Pathologic diagnosis and grading of dysplasia...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.08.004
更新日期：2007-12-01 00:00:00
abstract：:The effort to improve outcomes in esophageal cancer has included attempts at improving staging and patient selection. 2-Deoxy-2-[(18)F]fluoro-Dglucose positron emission tomography (FDG-PET) has been extensively studied in this context and has been widely accepted as a staging tool. Its role in restaging or assessing t...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2009.01.007
更新日期：2009-03-01 00:00:00
abstract：:Irritable bowel syndrome (IBS) is a complex clinical process with multiple pathophysiologic mechanisms. There has recently been a shift in the treatment of patients with severe IBS symptoms to disease-modifying therapies as opposed to symptomatic treatment. Because pathophysiologic differences exist between men and wo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.03.012
更新日期：2011-06-01 00:00:00
abstract：:The effect of Helicobacter pylori eradication treatment needs confirmation in patients with persistent symptoms and in those with complicated peptic ulcer. Endoscopic surveillance after eradication is needed in patients with advanced premalignant gastric lesions, previous early gastric cancer, gastric MALT lymphoma, a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2015.05.006
更新日期：2015-09-01 00:00:00
abstract：:The goal of antiviral treatment of chronic hepatitis B is to prevent the complications of cirrhosis, hepatic decompensation, HCC, and death. Because these clinical outcomes may take a long period of time to develop, it is important to use intermediate or surrogate end points to evaluate the efficacy and response to an...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.06.004
更新日期：2011-09-01 00:00:00
abstract：:Barium radiography of the gastrointestinal tract in patients with AIDS can assist in the evaluation of numerous problems including dysphagia, odynophagia, diarrhea, abdominal pain, symptoms of intermittent obstruction, and/or gastrointestinal bleeding. It can localize disease, evaluate complications, guide endoscopic ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:Determining the perioperative risks associated with surgical procedures performed in patients with HIV disease is a difficult and complex task. Because HIV is a contagious, blood-borne pathogen, it threatens the health and well-being of both patient and health care provider. Despite poor early results, there is now co...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70300-9
更新日期：1997-06-01 00:00:00
abstract：:Corticosteroids are a nonspecific immune modulator used in the treatment of ulcerative colitis. Topical and systemic forms of corticosteroids have been shown to be effective in induction of clinical remission and remain first-line therapy for acute severe ulcerative colitis. A large proportion of patients experience a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2020.08.001
更新日期：2020-12-01 00:00:00
abstract：:As the AIDS epidemic continues to grow, it becomes increasingly important that physicians are aware of the gastrointestinal and abdominal diseases specific to this group of patients. Most AIDS patients exhibit gastrointestinal symptoms at some time during the course of their disease. Clinical AIDS is often determined ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:The heterogeneous group of proteinases known as pepsinogens are synthesized, stored, and upon appropriate stimulation released from gastric mucosal chief cells. Under the acidic conditions of the lumen of the stomach, the proenzymes, pepsinogens, are converted to "pepsin", which plays an important physiologic role as ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:Choosing NSAID therapy remains confusing and controversial-the challenge for the clinician is to sum all the risks as well as analgesic and anti-inflammatory efficacy. COX-2 inhibitors are an important scientific advance in pain therapy, and using them in a safe and cost-effective manner is possible when all the compe...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2009.03.006
更新日期：2009-06-01 00:00:00
abstract：:Radiation therapy is a rapidly evolving field, and recent technical advances have spurred an increasing number of new treatments as well as marked improvements in previously existing treatments. Despite a growing body of published evidence demonstrating that radiotherapy for the treatment of pancreatic cancer is impro...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.12.011
更新日期：2012-03-01 00:00:00
abstract：:Ulcerative colitis and Crohn disease are chronic inflammatory diseases with typical onset in early adulthood. These diseases, therefore, can affect a woman throughout the many stages of her life, including menstruation, sexuality, pregnancy, and menopause. Unique health issues face women during these stages and can af...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2016.02.007
更新日期：2016-06-01 00:00:00
abstract：:Surveillance for hepatocellular carcinoma (HCC) has become routine despite a lack of evidence of efficacy. Suitable candidates for surveillance include patients with cirrhosis and some subsets of noncirrhotic chronic hepatitis B carriers. The best surveillance testis ultrasonography at 6- to 12-month intervals. Serolo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2004.04.012
更新日期：2004-09-01 00:00:00
abstract：:The ischemic bowel diseases are a heterogeneous group of disorders usually seen in elderly individuals. They represent ischemic damage to different portions [figure: see text] of the bowel and produce a variety of clinical syndromes and outcomes. Colonic ischemia is the commonest of these disorders and has a favorable...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70190-4
更新日期：2001-06-01 00:00:00
abstract：:The explanation as to why gastroesophageal reflux disease develops remains unanswered. We have learned much about the regulation of LES pressure, the single most important factor in the development of reflux disease. Our understanding of factors involved in the clearance of refluxed contents has also increased. The pr...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-06-01 00:00:00
abstract：:Striking geographical differences occur in the clinical presentation of hepatocellular carcinoma in high and low incidence areas. This tumor is also associated with a number of paraneoplastic phenomena that may antedate the clinical appearance. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-12-01 00:00:00
abstract：:The five different viruses that cause human viral hepatitis, A, B, C, D, and E share the unique property of hepatotropism. Identification of the nucleic acid sequences of each of these viruses, coupled with the application of recombinant DNA technology, has resulted in the rapid development of molecular diagnostic tec...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-09-01 00:00:00
abstract：:Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.07.003
更新日期：2018-12-01 00:00:00
abstract：:This article examines the transitions in pharmacological therapy for obesity. It reviews the current options approved by the Food and Drug Administration and several drugs approved for other indications that can be used to treat obesity as well. Because weight regulation is complex and redundant systems protect agains...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2010.01.001
更新日期：2010-03-01 00:00:00
abstract：:The past decade has seen the introduction of a number of new potent antimicrobial agents, including broad-spectrum beta-lactam compounds such as the ureidopenicillins, third-generation cephalosporins, carbapenems, and monobactams; combinations of penicillins with inhibitors of beta-lactamase; and the quinolones. Most ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:In the treatment of arthritis, NSAIDs are some of the most commonly used drugs, although the prescription of such drugs has been questioned due to their inherent risks for gastrointestinal compromise, platelet effects, and the potential for renal toxicity with long-term use. With the availability of celecoxib and rofe...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70226-0
更新日期：2001-12-01 00:00:00
abstract：:Corticosteroids are of proven value for the treatment of active ulcerative colitis and Crohn's disease, but are of little value for the maintenance of remission. The development of new steroid compounds with low systemic bioavailability should allow higher doses to be given for longer periods without risking serious a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as prima...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2019.08.005
更新日期：2019-12-01 00:00:00
abstract：:Because there are no reliable biological or laboratory markers associated with the condition, the diagnosis of irritable bowel syndrome(IBS) is based on patient descriptions of common symptoms such as abdominal pain accompanied by changes in stool form or frequency and associated symptoms such as bloating and distensi...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2005.03.001
更新日期：2005-06-01 00:00:00
abstract：:Treatment with a combination of radiation therapy and chemotherapy currently allows about 80 per cent of patients with epidermoid carcinomas of the anal canal to retain anorectal function, with about a 70 per cent likelihood of cure at 5 years. In these programs, radical surgery is reserved for the management of resid...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 00:00:00
abstract：:Ischemic injury to the gastrointestinal tract can threaten bowel viability with potential catastrophic consequences, including intestinal necrosis and gangrene. The presenting symptoms and signs are relatively nonspecific and diagnosis requires a high index of clinical suspicion. AMI often results from an embolus or t...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(03)00093-1
更新日期：2003-12-01 00:00:00
abstract：:Anal cancer is rare and this helps to explain why anal pre-neoplastic conditions are poorly understood, especially with regard to their natural history and management. Anal intraepithelial neoplasia is closely linked to human papillomavirus infection and is particularly common in homosexuals and in immunosuppressed pa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.08.001
更新日期：2007-12-01 00:00:00
abstract：:Rarely do otherwise safe drugs administered at recommended doses produce liver damage that may progress to liver failure and death. Because we are generally unable to identify the patients most susceptible to this "idiosyncratic" form of toxicity, many potentially useful medications are not made available to patients....
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:Adenomatous polyps are the benign precursors of colorectal adenocarcinoma. Colonic adenomas occur commonly in adults in Western countries. There is recent evidence that inheritance may play an important role in the etiology of these adenomatous polyps. Colonic adenomatous polyposis (numerous colonic adenomas) is the c...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-12-01 00:00:00
