Huang et al reported a strategy for conducting surveillance of a patient with gastric intestinal metaplasia without dysplasia. The authors are from Stanford University and University of Washington Seattle.
Patient selection: gastric intestinal metaplasia without dysplasia
Parameters:
(1) status of H. pylori infection
(2) risk for gastric cancer (race/ethnicity, family history, etc)
(3) extensive intestinal metaplasia based on mapping endoscopy
If the patient has gastritis due to H. pylori, then it should be eradicated.
If mapping endoscopy has not been performed, then it should be.
Risk Level
Extensive IM
Endoscopy Surveillance
low
no
none
low
yes
in 2 or 3 years
high
no
in 2 years
high
yes
in 1 or 2 years
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