Department of Pathology, Pusan National University Hospital and Pusan National University School of Medicine and BioMedical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Gastroenterology, Pusan National University Hospital and Pusan National University School of Medicine and BioMedical Research Institute, Pusan National University Hospital, Busan, Korea.
Histopathology. 2016 May;68(6):843-9. doi: 10.1111/his.12860. Epub 2015 Nov 9.
Previous reports have shown that gastric epithelial dysplasia (GED) limited to the crypt (gastric crypt dysplasia, GCD) is commonly identified at the periphery of gastric carcinoma. However, it is unknown whether GCD is endoscopically identifiable, and how it relates to classic GED lesions.
We investigated 1196 consecutive endoscopic resections of GED lesions between January 2011 and December 2014. We also evaluated clinicopathological features of these lesions, as well as the immunohistochemical expression of mucin (Muc)2, Muc5AC, Muc6, CD10, Ki67 and p53. We found 51 (4.3%) lesions composed microscopically of GCD among 1196 GED lesions. Those were elevated mucosal lesions (66.7%) similar in colour and texture to the adjacent mucosa (68.6%). GCD was likely to have an antropyloric location and a higher grade than the adenomatous type, similar to the foveolar and hybrid types (P < 0.05). A gastric immunophenotype was more common in GCD compared to adenomatous GED (P < 0.05). Ki-67- and p53-positive cells were more evident in GCD compared to the adjacent gastric mucosa.
Our results demonstrated that GCD can be an endoscopically identifiable lesion, sharing many similarities with foveolar and hybrid GED, for which it may represent a precursor lesion in the gastric carcinogenic sequence.
先前的报告表明，局限于隐窝的胃上皮异型增生（GED）（胃隐窝异型增生，GCD）通常在胃癌的周边被识别。然而，尚不清楚 GCD 是否可在临床上识别，以及它与经典的 GED 病变有何关系。
我们调查了 2011 年 1 月至 2014 年 12 月期间连续 1196 例 GED 病变的内镜切除术。我们还评估了这些病变的临床病理特征，以及黏蛋白（Muc）2、Muc5AC、Muc6、CD10、Ki67 和 p53 的免疫组织化学表达。我们发现 1196 例 GED 病变中有 51 例（4.3%）显微镜下由 GCD 组成。这些病变为高出黏膜的病变（66.7%），其颜色和质地与相邻黏膜相似（68.6%）。GCD 更可能位于贲门部，且其级别高于腺瘤型，类似于凹窝型和混合型（P < 0.05）。与腺瘤型 GED 相比，GCD 更常见胃免疫表型（P < 0.05）。与相邻胃黏膜相比，GCD 中 Ki-67 和 p53 阳性细胞更为明显。
我们的结果表明，GCD 可能是一种临床上可识别的病变，与凹窝型和混合型 GED 有许多相似之处，它可能代表胃癌发生序列中的一种前体病变。
