Endoscopic treatment of gastric adenocarcinoma of the fundic gland: a report of three cases and a literature review
10.3760/cma.j.issn.0254-9026.2023.01.015
- VernacularTitle:胃底腺型胃癌内镜诊治三例并文献复习
- Author:
Xue SUN
1
;
Na LIU
;
Jie LIU
;
Suyan CAO
;
Yan ZHANG
;
Jun DU
;
Li ZHAO
Author Information
1. 北京医院特需医疗部及全科医学科 国家老年医学中心 中国医学科学院老年医学研究院 100730
- Keywords:
Gastric fundics;
Stomach neoplasms;
Gastroscopes
- From:
Chinese Journal of Geriatrics
2023;42(1):80-85
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and summarize the clinical characteristics, endoscopic manifestations, pathology and treatment of gastric adenocarcinoma of the fundic gland(GA-FD)to promote clinicians' understanding of this disease.Methods:The clinical data of 3 patients with GA-FD admitted to Beijing Hospital from May 2020 to January 2022 were retrospectively analyzed.Among them, 2 presented with abdominal distension or abdominal pain.The other case was diagnosed during follow-up endoscopy after gastrectomy for gastric cancer.A diagnosis of GA-FD was made based on the results of white light imaging, magnifying endoscopy, pathology and immunohistochemistry.In addition, we reviewed the literature about GA-FD between January 1990 and April 2021 from both national and international reports of 195 cases.We analyzed and summarized the endoscopic and pathological characteristics of the disease and insights on its diagnosis and treatment.Results:Of all 198 cases, patients had a male/female ratio of 1.6/1.0 and an average age of 65.3 years(range: 39-87 years).79.82%(91/114)of the patients were negative for Helicobacter pylori.Gastroscopy showed that the average diameter was 8.97 mm, and 89.9%(178/198)of the patients had lesions infiltrating into the submucosa.91.98%(149/162)of the patients had gastric chief cells as the predominant cell type, 98.86%(130/140)had no lymphovascular invasion, and 97.6%(162/166)had no recurrence or metastasis.Conclusions:GA-FD is a rare gastric cancer, with low-grade atypia and highly differentiated tissues.The mechanisms of GA-FD are not clear and the disease is more commonly seen in the elderly.There is no obvious correlation between Helicobacter pylori infections and GA-FD.Gastric chief cells make up the predominant cell type.The results of endoscopy, pathology and immunohistochemistry can help confirm the diagnosis.The prognosis of most cases is good.
