胃底腺来源腺癌的临床病理学特征及基因分析

doi:10.20047/j.issn1673-7210.2023.05.26

Abstract
Figure/Table
References (25)
Related Citation (1)

Download: PDF (1097 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the clinicopathological features and genetic characteristics of gastric adenocarcinoma from the fundic gland. Methods From January 2017 to March 2022, seven cases in Linyi Tumor Hospital and two cases in Linyi Traditional Chinese Medicine Hospital of Shandong Province with adenocarcinoma from fundus gland were collected. The clinicopathological features were analyzed retrospectively, and immunohistochemical staining and next generation sequencing (NGS) were detected. Results Eight cases were diagnosed as gastric adenocarcinoma of fundus gland type (GA-FG), with the surface of the lesions covered by normal concave epithelium and low grade dysplasia below. One case was diagnosed as gastric adenocarcinoma of fundic gland mucosa type (GA-FGM) with mucosal structure disorder, neoplastic concave epithelium, and low-grade dysglandular mixed hyperplasia. No atrophy, intestinal metaplasia, and Helicobacter pylori infection were observed in the surrounding mucosa of seven GA-FG and one GA-FGM cases. Immunohistochemical staining showed that mucin (MUC) 6, pepsinogenⅠ, and H+/K+-adenosine triphosphatase (ATPase) were expressed in all the eight GA-FG cases, while MUC5AC was only expressed in normal concave epithelium. The tumor cells of one GA-FGM case expressed MUC6, MUC5AC, pepsinogenⅠand H+/K+-ATPase. The results of NGS detection showed that two GA-FG cases had GNAS missense mutations, and one GA-FGM case had BRAF and TP53 missense mutations. Conclusion GA-FG is a rare low-grade malignant tumor, which often infiltrates submucosa, but has a good prognosis in most cases, while GA-FGM has different clinicopathological characteristics and a slightly worse prognosis.

Key words： Fundic gland Gastric adenocarcinoma of fundus adenocarcinoma Gastric adenocarcinoma of gastric fundus mucosa GNAS mutation

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Xiaohong1 WANG Yu’e2 YANG Jing2 WANG Ye3 LIU Xiaojiang1 WANG Zhihui1 YAO Shaobo1

Cite this article:

ZHANG Xiaohong1 WANG Yu’e2 YANG Jing2 WANG Ye3 LIU Xiaojiang1 WANG Zhihui1 YAO Shaobo1. Clinicopathological features and genetics analysis of gastric adenocarcinoma from the fundic gland[J]. 中国医药导报, 2023, 20(5): 111-115.

URL:

https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.05.26 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I5/111

[1] WHO Classification of Tumours Editorial Board. WHO Classification of Tumours.Digestive system tumours [M]. Lyon：IARC，2019：83-84.
[2] Ueyama H，Yao T，Nagahara A，et al. Gastric adenocarcinoma of fundic gland type [J]. Stomach Intest，2018，53（5）：753-767.
[3] Tohda G，Osawa T，Asada Y，et al. Gastric adenocarcinoma of fundic gland type：endoscopic and clinicopathological features [J]. World J Gastrointest Endosc，2016，8（4）：244- 251.
[4] Chiba T，Kato K，Masuda T，et al. Clinicopathological features of gastric adenocarcinoma of the fundic gland（chief cell predominant type）by retrospective and prospective analyses of endoscopic findings [J]. Dig Endosc，2016，28（7）：722- 730.
[5] Benedict MA，Lauwers GY，Jain D. Gastric adenocarcinoma of the fundic gland type：update and literature review [J]. Am J Clin Pathol，2018，149（6）：461-473.
[6] Chan K，Brown IS，Kyle T，et al. Chief cell-predominant gastric polyps：a series of 12 cases with literature review [J]. Histopathology，2016，68（6）：825-833.
[7] Ushiku T，Kunita A，Kuroda R，et al. Oxyntic gland neoplasm of the stomach：expanding the spectrum and proposal of terminology [J]. Mod Pathol，2020，33（2）：206-216.
[8] Tajima Y，Murakami T，Saito T，et al. Distinct involvement of the sonic hedgehog signaling pathway in gastric adenocarcinoma of fundic gland type and conventional gastric adenocarcinoma [J]. Digestion，2017，96（2）：81-91.
[9] Li Y，Lu Y，Yu C，et al. Efficacy analysis of endoscopic submucosal dissection in gastric adenocarcinoma of fundic gland type：five cases of more than 36 months of follow-up [J]. Transl Cancer Res，2019，8（5）：1734-1740.
[10] Li C，Wu X，Yang S，et al. Gastric adenocarcinoma of the fundic gland type：clinicopathological features of eight patients treated with endoscopic submucosal dissection [J]. Diagn Pathol，2020，15（1）：131.
[11] Chen O，Shao ZY，Qiu X，et al. Multiple gastric adenocarcinoma of fundic gland type：a case report [J]. World J Clin Cases，2019，7（18）：2871-2878.
[12] 黄静雯，徐桂芳，秦睿璐，等.胃底腺型腺癌的临床与病理特征分析[J].中华消化内镜杂志，2021，38（4）：299- 304.
[13] Lee TI，Jang JY，Kim S，et al. Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor：a case report [J]. World J Gastroenterol，2015，21（16）：5099- 5104.
[14] 孙玮玮，张黎，顾敏敏，等.胃底腺型腺癌六例临床病理学特征[J].中华病理学杂志，2020，49（4）：343-347.
[15] 张静，刘鑫，张贺军，等.胃底腺癌11例临床病理分析[J].中国微创外科杂志，2020，20（4）：296-299.
[16] Iwamuro M，Kusumoto C，Nakagawa M，et al. Endoscopic resection is a suitable initial treatment strategy for oxyntic gland adenoma or gastric adenocarcinoma of the fundic gland type [J]. Sci Rep，2021，11（1）：7375.
[17] Takahashi H，Yao K，Ueo T，et al. Histological subtype of gastric adenocarcinoma：two cases of mixed fundic and pyloric mucosa-type adenocarcinoma [J]. Ecancermedicalscience，2020，14：1143.
[18] Ueyama H，Yao T，Akazawa Y，et al. Gastric epithelial neoplasm of fundic-gland mucosa lineage：proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type [J]. J Gastroenterol，2021，56（9）：814- 828.
[19] Hidaka Y，Mitomi H，Saito T，et al. Alteration in the Wnt/ β-catenin signaling pathway in gastric neoplasias of fundic gland（chief cell predominant） type [J]. Hum Pathol，2013，44（11）：2438-2448.
[20] Lee SY，Saito T，Mitomi H，et al. Mutation spectrum in the Wnt/β-catenin signaling pathway in gastric fundic gland- associated neoplasms/polyps [J]. Virchows Arch，2015，467（1）：27-38.
[21] Nomura R，Saito T，Mitomi H，et al. GNAS mutation as an alternative mechanism of activation of the Wnt/β-catenin signaling pathway in gastric adenocarcinoma of the fundic gland type [J]. Hum Pathol，2014，45（12）：2488-2496.
[22] Carter JM，Inwards CY，Jin L，et al. Activating GNAS mutations in parosteal osteosarcoma [J]. Am J Surg Pathol，2014，38（3）：402-409.
[23] 刘蕾，董新茜，范雪，等.胃底腺肿瘤12例临床病理及分子遗传学分析[J].临床与实验病理学杂志，2022，38（2）：147-151.
[24] Kato M，Uraoka T，Isobe Y，et al. A case of gastric adenocarcinoma of fundic gland type resected by combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique（CLEAN-NET）[J]. Clin J Gastroenterol，2015，8（6）：393-399.
[25] Uchida A，Ozawa M，Ueda Y，et al. Gastric adenocarcinoma of fundic gland mucosa type localized in the submucosa：a case report [J]. Medicine（Baltimore），2018，97（37）：e12341.