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World J Gastroenterol. Dec 28, 2022; 28(48): 6900-6908
Published online Dec 28, 2022. doi: 10.3748/wjg.v28.i48.6900
Confusion and prospects for carcinogenesis of gastric adenoma and dysplasia: What is the correct answer currently?
Shinichi Kinami, Sohsuke Yamada, Hiroyuki Takamura
Shinichi Kinami, Department of Surgical Oncology, Kanazawa Medical University, kahoku-gun 920-0293, Ishikawa, Japan
Sohsuke Yamada, Department of Clinical Pathology, Kanazawa Medical University, Uchinada 920-0293, Ishikawa, Japan
Hiroyuki Takamura, Department of Surgical Oncology, Kanazawa Medical University, Kahoku-gun 920-0293, Ishikawa, Japan
Author contributions: Kinami S was responsible for the scientific conception of the study and writing of the manuscript; Yamada S and Takamura H contributed to the drafting, editing, and critical revision of the manuscript; all authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest related to the publication of this study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shinichi Kinami, MD, PhD, Professor, Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, kahoku-gun 920-0293, Ishikawa, Japan. kinami@kanazawa-med.ac.jp
Received: September 15, 2022
Peer-review started: September 15, 2022
First decision: October 30, 2022
Revised: November 7, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 28, 2022
Processing time: 103 Days and 8 Hours
Core Tip

Core Tip: Gastric carcinogenesis occurs mostly de novo. Superficial gastric tumors can be roughly divided into the APC mutation type and the TP53 mutation type, which are mutually exclusive. APC-type tumors have low malignancy and develop into low-grade dysplasia, whereas TP53-type tumors have high malignancy and are considered cancerous even if they are small. For lesions diagnosed as category 3 or 4 in the Vienna classification system, endoscopic submucosal dissection and staging should be performed. If the tumor is diagnosed with lymphovascular or submucosal invasion, additional surgical treatment of gastrectomy with lymph node dissection is required.