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The diagnosis of chronic gastritis can be made from the macroscopic lesions seen on endoscopy, and the severity of the changes noted in the mucosa after biopsy under direct vision. Gastric intubation can also be used to confirm the pathological results. If the atrophied mucosa shows highly differentiated diffuse intestinal metaplasia, the examinations should be repeated at regular intervals, as they could herald the onset of malignant changes. The authors discovered 312 cases of intestinal metaplasia in 4 920 patients who had been gastroscoped in the Digestive Endoscopy Center of François-Moutier. A total of 157 of them, were noted to have very highly differentiated diffuse lesions, and 54 of these cases had at least yearly repeat gastroscopies. A diagnosis of intrinsic cancer was made in four patients, and this was confirmed by taking serial sections of the specimens removed.
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