Oxyntic Gland Neoplasms - From Adenoma to Advanced Gastric Cancer: A Review of 29 Cases.

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastric Cancer Pub Date : 2024-10-01 DOI:10.5230/jgc.2024.24.e30
Gi Hwan Kim, Jun Su Lee, Jeong Hoon Lee, Young Soo Park
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Abstract

Purpose: Oxyntic gland neoplasm (OGN) is a rare condition that can be classified as oxyntic gland adenoma (OGA) or gastric adenocarcinoma of fundic-gland type (GA-FG). GA-FG primarily presents as early gastric cancer, with only a few reported cases of advanced gastric cancer (AGC). We aimed to investigate the clinicopathological features of OGN and describe an aggressive variant.

Materials and methods: We investigated a total of 29 cases, including a patient with double primary cases, diagnosed with OGN or differentiated-type adenocarcinoma with GA-FG morphology, between November 2016 and April 2022. We analyzed 54 pathological specimens and reviewed their clinicopathological, endoscopic, and histological features. The lesions were reclassified as OGA or GA-FG, and immunohistochemical (IHC) staining for MUC-5AC and MUC-6 was performed on available resected GA-FG cases.

Results: The median patient age was 65 years and males accounted for 58.6% of patients. Most cases occurred in the body horizontally (69.0%) and on the greater curvature side cross-sectionally (48.3%). Endoscopically, type 0-IIa (41.4%) and a subepithelial tumor-like appearance (24.1%) were the most common findings. Histologically, there were 8 cases of OGA (27.6%) and 21 cases of GA-FG (72.4%). In GA-FG, MUC-6 was positive in 13 cases (81.3%), whereas MUC-5AC was positive in 8 cases (50.0%). Three cases presented as AGCs.

Conclusions: Although OGNs are generally considered low-grade, they can present as AGCs and may exhibit features of lymphovascular or perineural invasion. Recognizing the clinicopathological features and accurately diagnosing OGN are important for providing adequate treatment.

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卵巢腺瘤--从腺瘤到晚期胃癌:29 例病例回顾。
目的:胃底腺肿瘤(OGN)是一种罕见疾病,可分为胃底腺腺瘤(OGA)和胃底腺型胃腺癌(GA-FG)。GA-FG主要表现为早期胃癌,仅有少数病例报告为晚期胃癌(AGC)。我们旨在研究 OGN 的临床病理特征,并描述一种侵袭性变异:我们调查了2016年11月至2022年4月期间确诊为OGN或GA-FG形态的分化型腺癌的共29例病例,其中包括1例双原发病例患者。我们分析了 54 份病理标本,并回顾了其临床病理学、内镜和组织学特征。病变被重新分类为OGA或GA-FG,并对现有切除的GA-FG病例进行了MUC-5AC和MUC-6的免疫组化(IHC)染色:结果:患者的中位年龄为65岁,男性占58.6%。大多数病例横向发生在体部(69.0%),横截面发生在大弯侧(48.3%)。内镜下,最常见的发现是 0-IIa 型(41.4%)和上皮下肿瘤样外观(24.1%)。从组织学角度看,OGA 8 例(27.6%),GA-FG 21 例(72.4%)。在 GA-FG 中,13 例(81.3%)MUC-6 呈阳性,8 例(50.0%)MUC-5AC 呈阳性。3例表现为AGC:结论:尽管OGN一般被认为是低级别肿瘤,但它们也可能表现为AGC,并可能表现出淋巴管或神经周围侵犯的特征。认识临床病理特征并准确诊断 OGN 对提供适当的治疗非常重要。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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