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Clinicopathological features of gastric adenocarcinoma of the fundic gland (chief cell predominant type) by retrospective and prospective analyses of endoscopic findings
- Source :
- Digestive Endoscopy. 28:722-730
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- Background and Aim Gastric adenocarcinoma of the fundic gland type (chief cell predominant type) (GA-FG-CCP) is a variant of gastric adenocarcinoma with chief cell differentiation. GA-FG-CCP is rare and not well understood. The present study aimed to investigate the clinicopathological features of GA-FG-CCP using retrospective and prospective analyses of endoscopic findings. Methods A total of 20 patients including nine cases treated with endoscopic submucosal dissection (ESD) were diagnosed with GA-FG-CCP. Morphological changes were analyzed by retrospectively retracing past endoscopic records and following up after definitive diagnoses, including the status of Helicobacter pylori (H. pylori) infection. Results GA-FG-CCP were small and whitish lesions accompanied by atypical vascular growth and their macroscopic types were classified as 0-IIa (60%), 0-IIb (25%), and 0-IIc (15%), respectively. The lesions were found in the non-atrophic gastric mucosa of the upper (70%) or middle portion (30%), although gastric mucosal atrophy associated with current or past H. pylori infection was identified in 75% of cases. In the nine cases treated with ESD, submucosal invasion was identified in 80% of the resected lesions, but no lymphovenous infiltration was detected. Ki-67 labeling index of GA-FG-CCP was low at 3.2% and visible morphological changes were rarely detected during long-term endoscopic observation for 58.9 ± 13.1 months. Conclusions These data indicate that GA-FG-CCP, even when submucosal invasion occurs easily, might be of low-grade malignancy as long as it is the chief cell predominant type without other epithelial abnormalities. In addition, GA-FG-CCP might develop despite H. pylori infection or gastric mucosal atrophy.
- Subjects :
- Oncology
medicine.medical_specialty
Pathology
biology
business.industry
Gastroenterology
Fundic Gland
Retrospective cohort study
Helicobacter pylori
medicine.disease
Malignancy
biology.organism_classification
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
030220 oncology & carcinogenesis
Internal medicine
medicine
Gastric mucosa
Chief cell
Adenocarcinoma
030211 gastroenterology & hepatology
Radiology, Nuclear Medicine and imaging
business
Prospective cohort study
Subjects
Details
- ISSN :
- 09155635
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Digestive Endoscopy
- Accession number :
- edsair.doi...........bdc48e8c0521dfb112219f5915d4750f