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The efficacy of full-thickness endoscopic resection of subepithelial tumors in the gastric cardia

World Journal of Gastrointestinal Oncology 2023年第12期15卷 2111-2119页

作者： En-Pan Xu Zhi-Peng Qi Bing Li Zhong Ren Ming-Yan Cai Shi-Lun Cai Zhen-Tao Lyv Zhang-Han Chen Jing-Yi Liu Qiang Shi Yun-Shi Zhong Endoscopy Center Zhongshan Hospital Fudan UniversityShanghai 200032China

BACKGROUND gastric subepithelial tumors(SETs)may harbor potential *** it is well recognized that large SETs should be resected,the precise treatment strategy remains *** to surgical resection,endoscopic resection(ER)has many advantages;however,ER of SETs in the cardia is *** To evaluate the safety and efficacy of endoscopic full-thickness resection(EFTR)for the treatment of gastric cardia *** We retrospectively reviewed data from all patients with SETs originating from the muscularis propria layer in the gastric cardia that were treated by EFTR or submucosal tunneling ER(STER)at Zhongshan Hospital Fudan University between November 2014 and May *** characteristics and clinical outcomes,including procedure times and complications rates,were compared between groups of patients receiving EFTR and *** A total of 171 tumors were successfully removed[71(41.5%)tumors in the EFTR and 100(58.5%)tumors in the STER group].Gastrointestinal stromal tumors(GISTs)were the most common *** en bloc resection rate was 100%in the EFTR group vs 97.0%in STER group(P>0.05).Overall,the EFTR group had a higher complete resection rate than the STER group(98.6%vs 91.0%,Pgastric cardia SETs is a very promising method to facilitate complete resection with similar complications and reduced operative times compared to *** cases of suspected GISTs or an unclear diagnosis,EFTR should be recommended to ensure complete resection.

关键词： Endoscopic full-thickness resection Submucosal tunneling endoscopic resection Gastrointestinal stromal tumor gastric cardia gastric subepithelial tumors

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Heterotopic pancreatic tissue in the gastric cardia: A case report and literature review

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World Journal of Gastroenterology 2014年第44期20卷 16779-16781页

作者： Rafa? Filip Ewa Walczak Jacek Huk Rados?aw P Radzki Marek Bieńko Department of Clinical Endoscopy Institute of Rural Health Department of Internal Medicine and Arterial Hypertension Institute of Rural Health Department of Gastroenterology 2nd Provincial Hospital in Rzeszów Department of Animal Physiology University of Life Sciences in Lublin

The heterotopic pancreas, which is usually described as an untypical presence of pancreatic tissue without any anatomic or vascular continuity with the pancreas, is relatively rare. Clinical manifestations may include bleeding, inflammation, pain and obstruction; however, in most cases it remains silent and is diagnosed during autopsy. Here, we report a case of ectopic pancreatic lesion located in the gastric cardia. The patient was a 73-year-old woman who had a history (over four months) of chronic epigastric pain accompanied by heartburn. Esophagogastroduodenoscopy revealed inflammatory changes throughout the stomach and lower esophagus, as well as a flat polypoid mass with benign features located in the gastric cardia, approx. 10 mm below the “Z” line, measuring approx. 7 mm in diameter. Endoscopic biopsy forceps were used to remove the lesion. Histological examination of the lesion revealed the presence of heterotopic pancreatic tissue in the gastric mucosa. On the basis of the presented case, we suggest that pancreatic ectopia should be a part of differential diagnosis, not only when dealing with submucosal gastric lesions, but also with those that are small, flat and/or untypically located.

关键词： Pancreatic tissue Ectopia gastric cardia Gastroesophageal reflux disease Epigastric pain

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An Asian population-based survival analysis of patients with distal esophageal and gastric cardia adenocarcinomas

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Chinese Medical Journal 2012年第22期125卷 3981-3984页

作者： ZHENG Bin ZHENG Wei ZHU Yong WU Wei-dong CHEN Chun Fujian Med Univ Union Hosp Dept Thorac Surg Fuzhou 350001 Fujian Peoples R China

Background Gastroesophageal junction adenocarcinomas include adenocarcinomas of the distal esophagus （DE） and gastric cardia （GC）. It is controversial whether these tumors are the same entity and whether they have the same survival rates. Patients with DE and GC adenocarcinomas have a similar survival rate in the US; however, data are lacking in Asian countries. Therefore, we conducted a retrospective study to understand the implications of the tumor location in the survival of Asian patients. Methods A total of 209 patients with pathologically confirmed DE and GC adenocarcinomas, from 2005 to 2007, were included in the study. We identified patients with adenocarcinomas of the DE （DE group, n=91） and GC （GC group）（n=118）, We performed an unadjusted survival analysis using the Kaplan-Meier method, and used a Cox proportional hazards regression model to adjust for potential confounding covariates. Results We found no significant difference between the overall survival of the DE and GC groups. The 3-year survival rates were 44.8% and 53.0%, respectively, and the 5-year survival rates were 27.9% and 30.2%, respectively （P=0.162）. We found no significant difference in early staging, advanced staging, different T staging, and different N staging, between the groups. Both advanced post-operative N staging and advanced AJCC staging had a significant adverse effect on survival. Conclusions Patients with DE and GC adenocarcinomas have similar survival rates in the Asian population. Both post-operative N staging and AJCC staging are prognostic factors.

关键词： survival distal esophagus gastric cardia adenocarcinoma Asia

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Histochemical studies on intestinal metaplasia adjacent to gastric cardia adenocarcinoma in subjects at high-incidence area in Henan, north China

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World Journal of Gastroenterology 2005年第30期11卷 4634-4637页

作者： She-Gan Gao Li-Dong Wang Zong-Min Fan Ji-Lin Li Xin He Rui-Feng Guo Dong-Ling Xie Xin-Wei He Shan-Shan Gao Hua-Qin Guo Jun-Kuan Wang Xiao-Shan Feng Bao-Gen Ma Laboratory for Cancer Research College of Medicine Zhengzhou University Zhengzhou 450052 Henan Province China Department of Pathology Linzhou Esophageal Cancer Hospital Linzhou Henan Province China Dep-artment of Clinical Oncology The First Affiliated Hospital of Henan Science and Technology University Luoyang 471001 Henan Province China Department of Oncology Henan Tumor Hospital Zhengzhou 450003 Henan Province China

AIM： To characterize the histochemical type and pattern of intestinal metaplasia （IM） adjacent to gastric cardia adenocarcinoma （GCA） and distal gastric cancer （GC） in Unzhou, Henan Province, China. METHODS： Alcian-blue-periodic acid Schiff and high iron diamine-Alcian blue histochemical methods were performed on 142 cases of IM, including 49 cases of GCA and 93 cases of GC. All the patients were from Linzhou, Henan Province, China, the highest incidence area for both GCA and squamous cell carcinoma. Radio- or chemotherapy was not applied to these patients before surgery. RESULTS： The detection rate of IM in tissues adjacent to GCA tissues was 44.9%, which was significantly lower than that in GC tissues （80.64%, P〈0.01）. The rates of both incomplete small intestinal and colonic IM types identified by histochemistry in GCA tissues （31.82% and 63.64%, respectively） were significantly higher than those in GC （5.33% and 21.33%, respectively, P〈0.01）. CONCLUSION： IM in GCA and GC should be considered as a separate entity. Further research is needed to evaluate whether neoplastic progression of IM is related to its mucin profile in GCA.

关键词： gastric cardia Intestinal metaplasia Histochemistry

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