1
|
Guo BZ, Liu ZZ, Shen GF, Zhu F, Lian HF, Li X, Zheng JY, Li JP, Deng SM, Huang R. Clinicopathological features of gastric adenocarcinoma of fundic gland type. Shijie Huaren Xiaohua Zazhi 2023; 31:244-248. [DOI: 10.11569/wcjd.v31.i6.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND Gastric adenocarcinoma of fundic gland type (GA-FG) is a newly discovered type of gastric cancer in recent years, and it is a form of well-differentiated malignancy unlike conventional intestinal and diffuse gastric cancers. It is expected that GA-FG will account for an increasing proportion of all gastric cancers, but the current lack of knowledge among endoscopists and clinicopathologists may lead to misdiagnosis.
AIM To increase the diagnostic yield of GA-FG and reduce missed diagnosis and misdiagnosis, we conducted a systematic review of the endoscopic, clinical, and pathological features of GA-FG.
METHODS The clinical, pathological, and endoscopic data of patients with GA-FG reported in the Chinese and English literature published between January 2007 and March 2022 were collected from PubMed and CNKI and retrospectively analyzed.
RESULTS Data related to a total of 322 lesions in 320 patients with GA-FG were collected from 67 articles. Most of the lesions were located in the upper third of the stomach (81.6%), with an average lesion size of 9.66 mm (1 mm-85 mm), and approximately 76.88% of the lesions had an elevated gross morphology. Microvascular dilatation and disorganized or thickened microglandular structures were observed on the surface of the lesions by narrow band imaging. The main cell differentiation type accounted for approximately 74.84% of all lesions, which significantly expressed MUC6 and pepsinogen.
CONCLUSION The incidence of GA-FG is low. Endoscopic complete resection and surgical operation can achieve curative resection. The prognosis is good, but it tends to be misdiagnosed. The diagnosis should be combined with its clinicopathological characteristics to reduce the rate of misdiagnosis and missed diagnosis.
Collapse
|
2
|
Nishizawa T, Yoshida S, Toyoshima A, Matsuno T, Sakitani K, Kato J, Ebinuma H, Fujishiro M, Suzuki H, Toyoshima O. Increasing trend of Helicobacter pylori-uninfected gastric cancer without gastric atrophy. J Clin Biochem Nutr 2022; 71:245-248. [PMID: 36447484 PMCID: PMC9701589 DOI: 10.3164/jcbn.22-56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 09/19/2023] Open
Abstract
The prevalence of Helicobacter pylori (H. pylori) has decreased during several decades due to improvements in the sanitary environment in Japan. Consequently, a relative increase in the incidence of H. pylori-uninfected gastric cancer is expected. We analyzed the trends in H. pylori-uninfected gastric cancer. Two hundred fifty-eight patients with gastric cancer were retrospectively analyzed. The study was divided into four periods: 2008-2011 (first period), 2012-2014 (second period), 2015-2017 (third period), and 2018-2021 (fourth period). The status of H. pylori infection was divided into four categories: uninfected, successful eradication, spontaneous eradication, and persistent infection. Gastric mucosal atrophy was divided into six grades according to the Kimura-Takemoto classification. The proportion of H. pylori infections significantly changed over the study period (p = 0.007). In particular, the rate of H. pylori-uninfected gastric cancer tended to increase over time (0%, 2.9%, 4.9%, and 13.4% in the first, second, third, and fourth periods, respectively; p = 0.0013). The rate of no atrophy (C-0) in gastric cancer tended to increase over time (0%, 2.9%, 4.9%, and 11.0% in the first, second, third, and fourth periods, respectively; p = 0.0046). In conclusion, the rate of H. pylori-uninfected gastric cancer without gastric atrophy tended to increase over time.
Collapse
Affiliation(s)
- Toshihiro Nishizawa
- Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 157-0066, Japan
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita, Chiba 286-8520, Japan
| | - Shuntaro Yoshida
- Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 157-0066, Japan
| | - Akira Toyoshima
- Department of Colorectal Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Tatsuya Matsuno
- Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 157-0066, Japan
| | - Kosuke Sakitani
- Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 157-0066, Japan
- Department of Gastroenterology, Sakiatani Endoscopy Clinic, LoharuTsudanuma 4, 7-7-1 Yazu, Narashino, Chiba 275-0026, Japan
| | - Jun Kato
- Internal Medicine, Kato Medical Clinic, 2-22-11 Kitazawa, Setagaya-ku, Tokyo 155-0031, Japan
| | - Hirotoshi Ebinuma
- Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita, Chiba 286-8520, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hidekazu Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Osamu Toyoshima
- Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 157-0066, Japan
| |
Collapse
|
3
|
Iwamuro M, Kusumoto C, Nakagawa M, Matsueda K, Kobayashi S, Yoshioka M, Inaba T, Toyokawa T, Sakaguchi C, Tanaka S, Tanaka T, Okada H. Endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without Helicobacter pylori infection: a retrospective observational study. BMC Gastroenterol 2022; 22:294. [PMID: 35692036 PMCID: PMC9188703 DOI: 10.1186/s12876-022-02368-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type have not been fully investigated in relation to Helicobacter pylori infection status. We compared the morphology, color, and location of these lesions between patients with and without H. pylori infection. METHODS We retrospectively enrolled 165 patients (180 lesions) from 10 institutions. We divided the patients into the (i) Hp group (patients with current H. pylori infection [active gastritis, n = 13] and those with past infection [inactive gastritis, n = 76]) and (ii) uninfected group (H. pylori-uninfected patients, n = 52). We compared the clinical and endoscopic features of the two groups. We also performed an analysis between (i) lesions with atrophy of the surrounding gastric mucosa (atrophy group) and (ii) lesions without atrophy of the surrounding gastric mucosa (non-atrophy group). RESULTS The average age was older in the Hp group than in the uninfected group (68.1 ± 8.1 vs. 63.4 ± 8.7 years, p < 0.01). Although the difference was not statistically significant (p = 0.09), multiple lesions were observed in 9 of 89 patients (10.1%) in the Hp group and in only 1 of 52 patients (1.9%) in the uninfected group. Meanwhile, significant differences were observed in the prevalence of lesions located in the gastric fornix or cardia (uninfected group: 67.3% vs. Hp group: 38.0%, p < 0.01), with an elevated morphology (80.0% vs. 56.0%, p < 0.01), with a subepithelial-like appearance (78.2% vs. 42.0%, p < 0.01), and with a color similar to that of the peripheral mucosa (43.6% vs. 25.0%, p = 0.02). The male-to-female ratio, lesion size, and presence or absence of vascular dilatation or black pigmentation on the surface were not different between the two groups. In the analysis comparing lesions with and without mucosal atrophy, the prevalence of multiple lesions was significantly higher (p = 0.02) in the atrophy group (5/25 patients, 20.0%) than in the non-atrophy group (7/141 patients, 5.0%). CONCLUSIONS The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without H. pylori infection.
Collapse
Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.
| | - Chiaki Kusumoto
- Department of Gastroenterology, Nippon Kokan Fukuyama Hospital, 1844 Tsunoshita, Daimon-cho, Fukuyama, Hiroshima, Japan
| | - Masahiro Nakagawa
- Department of Endoscopy, Hiroshima City Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Sayo Kobayashi
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, Hiroshima, 721-8511, Japan
| | - Masao Yoshioka
- Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, Okayama, 700-8511, Japan
| | - Tomoki Inaba
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-cho, Takamatsu, Kagawa, 760-8557, Japan
| | - Tatsuya Toyokawa
- Department of Gastroenterology, Fukuyama Medical Center, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima, 720-8520, Japan
| | - Chihiro Sakaguchi
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-cho, Matsuyama, Ehime, 791-0280, Japan
| | - Shouichi Tanaka
- Department of Gastroenterology, Iwakuni Clinical Center, 1-1-1 Atago-cho, Iwakuni, Yamaguchi, 740-8510, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| |
Collapse
|