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Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2022; 14(2): 396-412
Published online Feb 15, 2022. doi: 10.4251/wjgo.v14.i2.396
Gastric epithelial histology and precancerous conditions
Hang Yang, Wen-Juan Yang, Bing Hu
Hang Yang, Wen-Juan Yang, Bing Hu, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Yang H and Hu B conceived the study; Yang H drafted the article; Yang H, Yang WJ and Hu B reviewed the article; the first two authors contributed equally to this paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: All authors have no potential conflict of interest to disclose.
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: Bing Hu, MD, Professor, Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. hubingnj@163.com
Received: September 7, 2021
Peer-review started: September 7, 2021
First decision: November 8, 2021
Revised: November 8, 2021
Accepted: January 5, 2022
Article in press: January 5, 2022
Published online: February 15, 2022
Processing time: 156 Days and 5.6 Hours
Abstract

The most common histological type of gastric cancer (GC) is gastric adenocarcinoma arising from the gastric epithelium. Less common variants include mesenchymal, lymphoproliferative and neuroendocrine neoplasms. The Lauren scheme classifies GC into intestinal type, diffuse type and mixed type. The WHO classification includes papillary, tubular, mucinous, poorly cohesive and mixed GC. Chronic atrophic gastritis (CAG) and intestinal metaplasia are recommended as common precancerous conditions. No definite precancerous condition of diffuse/poorly/undifferentiated type is recommended. Chronic superficial inflammation and hyperplasia of foveolar cells may be the focus. Presently, the management of early GC and precancerous conditions mainly relies on endoscopy including diagnosis, treatment and surveillance. Management of precancerous conditions promotes the early detection and treatment of early GC, and even prevent the occurrence of GC. In the review, precancerous conditions including CAG, metaplasia, foveolar hyperplasia and gastric hyperplastic polyps derived from the gastric epithelium have been concluded, based on the overview of gastric epithelial histological organization and its renewal.

Keywords: Gastric cancer; Gastric precancerous conditions; Gastric epithelium; Diagnosis; Histopathology

Core Tip: We provided a detailed overview of gastric epithelial organization and its renewal and reviewed precancerous conditions including chronic atrophic gastritis, spasmolytic polypeptide-expressing metaplasia, intestinal metaplasia, foveolar hyperplasia and gastric hyperplastic polyps derived from gastric epithelium based on histological perspective, covering their epidemiology, clinical management and advances, histological structure, causes and potential origin and reversibility. The origins, processes and reversibility are the main controversial topics. More clinical and basic research on molecular alterations of these gastric lesions may shed light on the controversies.