Published online Oct 27, 2026. doi: 10.4240/wjgs.122120
Revised: July 28, 2026
Accepted: August 14, 2026
Published online: October 27, 2026
Processing time: 145 Days and 18.5 Hours
Gastric precancerous lesions, including mucosal atrophy, intestinal metaplasia, and intraepithelial neoplasia, may persist after endoscopic submucosal dissection (ESD) for early gastric cancer, contributing to an annual incidence of metach
To evaluate the efficacy and safety of HJD in combination with conventional Western medical therapy for gastric precancerous lesions after ESD for early gastric cancer.
This retrospective study included 236 patients with gastric precancerous lesions who underwent ESD for early gastric cancer at the Third Affiliated Hospital of Beijing University of Chinese Medicine between January 2020 and January 2026. Patients were classified according to treatment regimen into an observation group (n = 119) and a control group (n = 117). The control group received a proton pump inhibitor plus with gastric mucosal protective agents, whereas the observation group received HJD in addition to the control regimen. Outcomes included histopathologic response, overall clinical efficacy, TCM syndrome scores, gastric function markers, such as pepsinogen I, pepsinogen II, the pepsinogen I/II ratio, and gastrin-17, serum inflammatory factors [interleukin (IL) 6, IL-8 and tumor necrosis factor-α], gastrointestinal quality-of-life index scores, and adverse events. The development of metachronous gastric cancer and progression of precancerous lesions were also assessed during follow-up.
Histological reversal and improvement rates were significantly higher in the observation group than in the control group (21.0% vs 10.3% and 42.0% vs 29.1%, respectively; both P < 0.05), as was the overall clinical response rate (63.0% vs 39.3%, P < 0.05). Histopathological and TCM syndrome scores and serum inflammatory markers (IL-6, IL-8 and tumor necrosis factor-α) were significantly lower in the observation group, whereas gastric function indices (pepsinogen I, the pepsinogen I/II ratio, and gastrin-17) and gastrointestinal quality-of-life index scores were significantly higher (all P < 0.05). The cumulative incidence of metachronous gastric cancer was lower in the observation group than in the control group (1.7% vs 5.4%), as was the rate of precancerous lesion progression (7.8% vs 18.8%). Cox regression analysis identified HJD treatment as an independent protective factor (hazard ratio = 0.385, P = 0.015).
In this retrospective clinical study, HJD combined with conventional Western medical therapy was associated with histopathological improvement of gastric precancerous lesions after ESD for early gastric cancer, alleviation of clinical symptoms, improved gastric function and quality of life, and reduced systemic inflammation. HJD treat
Core Tip: Huazhuojiedu decoction combined with conventional Western therapy significantly improves histopathological outcomes in patients with gastric precancerous lesions after endoscopic submucosal dissection. This study demonstrates enhanced reversal and improvement rates, enhanced gastric function (pepsinogen I, pepsinogen I/II ratio, gastrin-17), and reduced inflammatory cytokines (interleukin-6, interleukin-8, tumour necrosis factor-α). Importantly, combination therapy is associated with a lower incidence of metachronous gastric cancer and reduced progression of precancerous lesions during follow-up. These findings suggest that Huazhuojiedu decoction may exert protective effects through anti-inflammatory and multi-target regulatory mechanisms, offering a promising integrative strategy for post-endoscopic submucosal dissection management, although further randomized controlled trials are required for confirmation.