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World Journal of Gastroenterology 2016年第48期22卷 10523-10531页

作者： Masaki Miyazawa Mitsuru Matsuda Masaaki Yano Yasumasa Hara Fumitaka Arihara Yosuke Horita Koichiro Matsuda Akito Sakai Yatsugi Noda Department of Internal Medicine Toyama Prefectural Central Hospital

Gastric adenocarcinoma of the fundic gland(chief cellpredominant type, GA-FG-CCP) is a rare variant of welldifferentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from the gastric mucosa of the fundic gland region without chronic gastritis or intestinal metaplasia. The majority of GA-FG-CCPs exhibit either a submucosal tumor-like superficial elevated shape or a flat shape on macroscopic examination. Narrow-band imaging with endoscopic magnification may reveal a regular or an irregular microvascular pattern, depending on the degree of tumor exposure to the mucosal surface. Pathological analysis of GA-FG-CCPs is characterized by a high frequency of submucosal invasion, rare occurrences of lymphatic and venous invasion, and low-grade malignancy. Detection of diffuse positivity for pepsinogen-I by immunohistochemistry is specific for GA-FG-CCP. Careful endoscopic examination and detailed pathological evaluation are essential for early and accurate diagnosis of GA-FG-CCP. Nearly all GA-FG-CCPs are treated by endoscopic resection due to their small tumor size and low risk of recurrence or metastasis.

关键词： Narrow-band imaging Pepsinogen-I fundic gland Gastric adenocarcinoma Chief cell

Gastric adenocarcinoma of fundic gland type with signet-ring cell carcinoma component: A case report and review of the literature

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World Journal of Gastroenterology 2018年第26期24卷 2915-2920页

作者： Keita Kai Masaaki Satake Osamu Tokunaga Department of Pathology Saga University Hospital Department of Gastroenterology Koga Hospital 21 Department of Pathology Shin Koga Hospital

A depressed lesion was found at a gastric angle of 76-yearold Japanese woman by esophagogastroduodenoscopy. Four years prior, she was diagnosed with a Helicobacter pylori infection but no eradication was performed. The pathological diagnosis of biopsy specimens was signet-ring cell carcinoma. Endoscopic submucosal dissection(ESD) was performed. Histopathological examination of the ESD specimen revealed proliferation of well-differentiated tubular adenocarcinoma mimicking fundic gland cells at the deep layer of the lamina propria mucosae. These tumor cells expressed focally pepsinogen-Ⅰ, diffusely MUC6, and scattered H^+/K^+ ATPase according to immunohistochemistry. Therefore, we diagnosed this tumor as gastric adenocarcinoma of fundic gland type(GA-FG). Adjacent to the GA-FG, proliferation of signet-ring cell carcinoma which diffusely expressed MUC 2 and MUC 5AC was observed. Intestinal metaplasia was focally observed in the surrounding mucosa of the signet-ring cell carcinoma. To the best of our knowledge, this is the first case report of GA-FG with a signet-ring cell carcinoma component. The origin of signet-ring cell carcinoma, i.e., whether it accidentally arose from a non-neoplastic mucosa and coexisted with the GA-FG or dedifferentiated from the GA-FG is unclear at present. We expect the accumulation of similar cases and further analysis to clarify this issue.

关键词： Gastric adenocarcinoma of fundic gland type Endoscopic submucosal dissection Helicobacter pylori Intestinal metaplasia Signet-ring cell carcinoma

Multiple gastric adenocarcinoma of fundic gland type: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2871-2878页

作者： Ou Chen Ze-Yong Shao Xiong Qiu Guang-Ping Zhang Department of Gastroenterology Ya’an People’s HospitalYa’an 625000Sichuan ProvinceChina Department of Pathology Ya’an People’s HospitalYa’an 625000Sichuan ProvinceChina 不详

BACKGROUND In recent years, there have been reports of a new histological type of gastric cancer, termed gastric adenocarcinoma of the fundic gland (GA-FG). This disease entity presents differentiation towards the fundic gland, especially chief cellpredominant differentiation (GA-FG-CCP). GA-FG-CCP easily invades into the submucosa but rarely shows metastasis. The reports mostly describe primarily single lesions. Herein, we report a case with multiple lesions, and summarize the clinicopathologic characteristics of multiple cases. CASE SUMMARY A 55-year-old woman underwent upper gastrointestinal endoscopy screening. Two whitish lesions on the anterior wall of the gastric corpus and the gastric fundus were detected. The patient had previously received Helicobacter pylori eradication therapy. The mucosa was characterized as grade C-2 atrophic gastritis. We diagnosed the patient with multiple GA-FG (GA-FG-CCP) by hematoxylin and eosin (HE) staining and immunohistochemical staining of the endoscopic biopsy. Upon performing endoscopic submucosal dissection (ESD), one lesion was not found, but the scar from the biopsy was visible;the mucularis mucosa of the biopsy and ESD-resected specimen were intact. The two lesions showed no lymphatic nor venous invasion. The resection performed appeared to be relatively curative. CONCLUSION Cases of multiple GA-FG-CCP are very rare in clinical practice. Most of its clinicopathologic characteristics are similar to those of a single lesion. Our case provides diagnostic and therapeutic information about GA-FG-CCP with multiple lesions.

关键词： Gastric adenocarcinoma of the fundic gland Multiple lesions Pepsinogen-I Endoscopic submucosal dissection Case report

Gastric adenocarcinoma of fundic gland type after Helicobacter pylori eradication:A case report

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World Journal of Clinical Cases 2019年第13期7卷 1696-1702页

作者： Ya-Nan Yu Xiao-Yan Yin Qi Sun Hua Liu Qi Zhang Yun-Qing Chen Qing-Xi Zhao Zi-Bin Tian Department of Gastroenterology the Affiliated Hospital of Qingdao University Qingdao 266003 Shandong Province China Department of Pathology the Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing 210008 Jiangsu Province China Department of Pathology the Affiliated Hospital of Qingdao University Qingdao 266003 Shandong Province China

BACKGROUND Gastric adenocarcinoma of fundic gland type (GA-FG) has recently been proposed as a novel histological type of gastric cancer. CASE SUMMARY We report a case of GA-FG in a 77-year-old Chinese woman with epigastric distention who was referred to endoscopy for the management of an incidentally found submucosal tumor-like elevated lesion in the lower part of the gastric body. The tumor occurred after Helicobacter pylori (H. pylori) eradication therapy without long-term use of proton pump inhibitors. Complete and curable removal of the tumor was performed by endoscopic submucosal dissection. Histopathological findings showed numerous cells with basophilic cytoplasm and mildly atypical nuclei-like chief cells of the fundic gland. The tumor was observed to have the so-called “endless glands” pattern of the well-differentiated mixed phenotype. A safe resection margin without lymphatic and venous invasion was observed. As the tumor occurred after H. pylori eradication therapy, it is unknown whether there was a relationship with H. pylori eradication. The patient will be followed up by periodic gastroscopic observation. CONCLUSION In conclusion, we report a case of GA-FG after H. pylori eradication therapy without long-term proton pump inhibitors use. Further analysis of similar cases will reveal the clinical behavior of GA-FG.

关键词： Gastric adenocarcinoma fundic gland Helicobacter pylori Eradication Case report

Signet-ring cell carcinoma arising from a fundic gland polyp in the stomach

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World Journal of Gastroenterology 2014年第47期20卷 18044-18047页

作者： Yong Seol Jeong Sung Eun Kim Mi-Jung Kwon Jae Yong Seo Hyun Lim Ji Won Park Ho Suk Kang Sung Hoon Moon Jong Hyuk Kim Choong Kee Park Department of Internal Medicine University of Hallym College of MedicineHallym University Sacred Heart Hospital Department of Pathology University of Hallym College of MedicineHallym University Sacred Heart Hospital

fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually ***,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric *** we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the *** tumor was completely excised by endoscopic snare *** should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.

关键词： fundic gland polyp Signet ring cell

Gastric adenocarcinoma of fundic gland type: Five cases treated with endoscopic resection

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World Journal of Gastroenterology 2015年第26期21卷 8208-8214页

Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was *** treated five cases of GA-FG with endoscopic submucosal *** tumors were small and located in the upper third of the *** tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱ***-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the *** tumors arose from the deep layer of the lamina propria mucosae and showed submucosal *** invasion was seen only in one case,while no venous invasion was *** tumors were positive for pepsinogen-Ⅰ and MUC6 by *** showed p53 overexpression,and the labeling index of Ki-67 was low in all *** cases have been free from recurrence or ***,we discussed the clinicopathological features of GA-FG in comparison with past reports.

关键词： Gastric adenocarcinoma of fundic glandtype Pepsinogen-Ⅰ Chief cell Endoscopic diagnosis Narrow-band imaging with magnifying endoscopy Endoscopic submucosal dissection

Gastric adenocarcinoma of fundic gland type:Endoscopicand clinicopathological features

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 244-251页

作者： Gen Tohda Takeshi Osawa Yasuyuki Asada Masaki Dochin Shintarou Terahata Department of Gastroenterology Fukui Kosei HospitalFukui 918-8537Japan Department of Surgery Fukui Kosei HospitalFukui 918-8537Japan Department of Diagnostic Pathology Tonami General HospitalTonami 939-1395Japan

Gastric adenocarcinoma of fundic gland type(GA-FG) with chief cell differentiation was recently proposed as an extremely rare type of gastric adenocarcinoma. Here, we report 4 cases of GA-FG with chief cell differentiation. Endoscopic features included a submucosal tumor shape or a flat shape, whitish discoloration and dilated vessels on the surface. The tumors were located in the upper or middle third of the stomach. All cases were preoperatively diagnosed as GA-FG by biopsy, and endoscopic submucosal dissection was performed. Resected specimens revealed well-differentiated adenocarcinomas resembling chief cells. Tumor cells were diffusely positive for pepsinogen-Ⅰ, but partially positive for H+/K+-ATPase in scattered locations around the tumor margin. Despite the presence of minimal invasion of the carcinoma into the submucosal layer, which was observed in two cases, neither lymphatic nor venous invasion was detected in any of the cases. Finally, all cases showed less aggressive clinical behavior with low grade malignancy.

关键词： Early gastric cancer Low grade malignancy fundic gland type Chief cells Endoscopic submucosaldissection

Changes in the spectrum of gastric polyps in the Chinese population

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World Journal of Gastroenterology 2015年第33期21卷 9758-9764页

作者： Nan-Nan Fan Jing Yang Gang Sun Zhong-Sheng Lu En-Qiang Ling Hu Xiang-Dong Wang Yun-Sheng Yang Institute of Digestive Diseases Chinese PLA General Hospital Nankai University School of Medicine

AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten ***: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD *** records of 4043 patients diagnosed with gastric polyps were recalled for *** including demographics,information on polyps such as location,pathological diagnosis,reflux esophagitis and Helicobacter pylori infection were *** focused on epithelial polyps,especially hyperplastic polyps,fundic gland polyps and adenomas,and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists,based on the updated *** explore the age distribution of gastric polyps over time,we divided patients with polyps into four groups: A(aged 60 years).Differences in localization,age,and sex distribution of gastric polyps were analyzed by statistical ***: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center,of which 4043 cases were diagnosed with gastric polyps confirmed by *** were 2574(63%) female and 1469(37%) male patients with an average age of 54.7 *** overall prevalence of gastric polyps was 2.6%(4043/157902).Our database demonstrated a rising prevalence of gastric polyps over the decade,increasing from 1.0%(80/8025) to 4.70%(828/17787) between 2004 and *** has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19%(15/80) to 77%(638/828) and hyperplastic polyps decreasing from 65%(52/80) to 15%(123/828).Moreover,data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum,making up 81.3%(1562/1921).Location and age distribution of gastri

关键词： Gastric polyps Hyperplastic polyps fundic gland po

Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study

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World Journal of Gastrointestinal Endoscopy 2015年第10期7卷 995-1002页

作者： Sherif Elhanafi Mohammed Saadi Wynee Lou Indika Mallawaarachchi Alok Dwivedi Marc Zuckerman Mohamed O Othman Division of Gastroenterology Department of Internal Medicine Paul L.Foster School of Medicine Texas Tech University Health Sciences Center Division of Biostatistics and Epidemiology Department of Biomedical Sciences Paul L.Foster School of Medicine Texas Tech University Health Sciences Center Gastroenterology and Hepatology Section Department of Internal Medicine Baylor College of Medicine

aim:To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori(***)status in a predominantly Hispanic population.m ETHODS:We conducted a retrospective study of all esophagogastroduodenoscopies performed at our ***,endoscopic and histopathological data were *** of patients into Hispanic and Non-Hispanic was based on *** without resection/biopsy were not included in the *** of polyps type was based on histological *** way analysis of variance was used to compare continuousvariables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp *** and adjusted comparisons of demographic and clinical characteristics were performed according to the *** status and polyp type using logistic ***:Of 7090 patients who had upper endoscopy,335 patients had gastric polyps(4.7%).Resection or biopsy of gastric polyps was performed in 296 patients(88.4%)with a total of 442 polyps removed or *** 296 patients,87(29%)had hyperplastic polyps,82(28%)had fundic gland polyps and 5(1.7%)had adenomatous *** polyps were significantly associated with positive *** status compared with fundic gland polyps(OR=4.621;95%CI:1.92-11.13,P=0.001).Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps(OR=6.903;95%CI:1.41-33.93,P=0.0174).Out of 296 patients,30(10.1%)had a followup endoscopy with a mean duration of 26±16.3 *** development of cancer was not noted in any of the patients during follow up *** ON:Gastric hyperplastic polyps were significantly associated with positive *** status and portal hypertensive gastropathy as compared with fundic gland polyps.

关键词： Gastric polyps fundic gland polyp Hyperplasticpolyp Adenomatous polyps Chronic gastritis Helicobacter pylori

Risk of colorectal polyps in patients with sporadic gastric polyps:A case-control study

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World Journal of Gastrointestinal Endoscopy 2013年第5期5卷 240-245页

作者： Daniel Gustavo Cimmino José Manuel Mella Pablo Luna Raquel González Lisandro Pereyra Carolina Fischer Adriana Mohaidle Beatriz Vizcaino Mario Andres Medrano Adrián Hadad Silvia Pedreira Luis Boerr Digestive Endoscopy and Gastroenterology Units Internal Medicine DepartmentHospital AlemánBuenos AiresCP 1118Argentina

AIM:To assess the risk of colonic polyps,adenomas and advanced neoplastic lesions(ANL) in patients with sporadic gastric polyps,especially those with fundic gland polyps(FGP).METHODS:Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed.A case-control study was carried out,calling patients with gastric polyps as 'cases' and patients without gastric polyps as 'controls'.The risk of colonic polyps,adenomas and ANL(villous component ≥ 25%,size ≥ 10 mm,or high grade dysplasia) was assessed [odds ratio(OR) and its corresponding 95%CI].RESULTS:Two hundred and forty seven patients were analyzed:78 with gastric polyps(cases) and 169 without gastric polyps(controls).Among the cases,the majority of gastric polyps were FGP(80%,CI:69-88) and hyperplastic(20%,CI:12-31);25% had colonic polyps(25% hyperplastic and 68% adenomas,from which 45% were ANL).Among the controls,20% had colonic polyps(31% hyperplastic and 63% adenomas,from which 41% were ANL).The patients with sporadic FGP had an OR of 1.56(CI:0.80-3.04) for colonic polyps,an OR of 1.78(CI:0.82-3.84) for colonic adenomas,and an OR of 0.80(CI:0.21-2.98) for *** results were found in patients with gastric polyps in ***:The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.

关键词： Colorectal polyps Advanced neoplastic lesions Gastric polyps fundic gland polyps gastric polyps Case-control study