Endoscopic and Clinicopathological Features of Gastric Adenocarcinoma of the Fundic Gland Type and Oxyntic Gland Adenoma
10.3969/j.issn.1008-7125.2024.06.005
- VernacularTitle:胃底腺型肿瘤的内镜和临床病理特点分析
- Author:
Shan WU
1
;
Yueqin QIAN
;
Jie XIA
;
Jun ZHOU
;
Xinjian WAN
;
Zhixia DONG
Author Information
1. 上海交通大学医学院附属第六人民医院消化内镜中心(200233)
- Publication Type:Journal Article
- Keywords:
Early Gastric Cancer;
Gastric Adenocarcinoma of the Fundic Gland Type;
Oxyntic Gland Adenoma;
Endoscopic Submucosal Dissection
- From:
Chinese Journal of Gastroenterology
2024;29(6):346-351
- CountryChina
- Language:Chinese
-
Abstract:
Background:Gastric adenocarcinoma of the fundic gland type(GA-FG)and oxyntic gland adenoma(OGA)are rare variants of the gastric neoplasms exhibiting fundic differentiation.However,their endoscopic recognition and diagnosis is difficult in clinical practice.Aims:To explore the endoscopic and clinicopathological features of GA-FG and OGA,and to discuss the surgical methods and clinical outcomes.Methods:A retrospective analysis was conducted on 19 cases with a total of 22 lesions diagnosed as GA-FG or OGA through histopathology at the Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to May 2023.Data on the diagnosis,treatment and follow-up among these patients were collected and analyzed.Results:Females were slightly more than males(12:7),with an average age of 54 years.Eighteen patients had single lesions,while one had 4 synchronous multifocal lesions.All the lesions located in the non-atrophic gastric fundic area of the upper and middle third of the stomach.Nine lesions were misdiagnosed as gastric fundic gland polyps initially.The tumors were small,with the average diameter of 7.4 mm.Most of the lesions(77.3%)showed fading or whitening changes under white light endoscopy.While under magnifying endoscopy with narrow-band imaging,obscure demarcation line,and dilated intervening part and crypt-opening could be observed in over half of the lesions,but irregular microvascular pattern was absent.Six lesions exhibited submucosal infiltration(GA-FG)without lymphovascular invasions.Eighteen lesions were diagnosed as chief cell predominant type,one was parietal cell predominant type,and three were mixed type.Endoscopic submucosal dissection and endoscopic mucosal resection were performed in 17 cases.No severe perioperative complications occurred,and no local recurrence and metastasis were detected during follow-up period.Conclusions:GA-FG and OGA mainly occur in the non-atrophic gastric fundic area,with small lesions exhibiting fading changes under endoscopy.The pathological type is primarily chief cell predominant type.This kind of lesion can be easily misdiagnosed as gastric fundic gland polyps.Endoscopic therapy appears to be effective and safe for them with a favorable prognosis.
