Department of Gastrointestinal Surgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China.
Ann Palliat Med. 2020 Sep;9(5):3668-3677. doi: 10.21037/apm-20-1253.
Gastric cystica profunda (GCP) is a rare disease characterized by multiple cystic lesions in the mucosa and/or submucosal layer. Usually, GCP occurs in stomachs that have previously been operated on. If there is no postoperative pathological results, it is challenging to diagnose GCP based on nonspecific clinical symptoms and imaging findings. This report aimed to provide a comprehensive overview of all cases of GCP reported to date. A comprehensive literature search was conducted for all reported GCP cases between 1972 and 2014. The keywords searched included "gastritis cystica profunda", "submucosal cysts of the stomach", and "heterotopic submucosal gastric glands". One retrospective case from our group was also reported and compared with those from the existing literature. A total of 52 cases were found including 37 (71.2%) men and 15 (28.8%) women (M/F ratio =2.5). The mean age of the patients was 59.9 (range, 39-91) years old. Among the cases, 58.8% (n=30) of lesions were located in the gastric body, 25.5% (n=13) of lesions were located in the fundus, 19.6% (n=9) of lesions were located in the antrum, and 3.9% (n=2) of lesions were located in the cardia, while 1 case was in the prepyloric lesion and 1 case was at the anastomotic site. Of the patients, 52% (n=26) had previously received gastric surgery. The main manifestations of GCP included abdominal pain (n=14, 36.8%) and gastrointestinal bleeding (including hematemesis and melena, n=7, 18.4%). Only 4 of the 52 cases were diagnosed before surgery, and the rest were diagnosed through postoperative histopathologic examination. GCP is difficult to correctly diagnose preoperatively due to its relative rarity and lack of typical clinical symptoms. Histopathological examination should be used for correct diagnosis. Complete surgical removal of the GCP is widely considered as the best treatment option.
胃底腺深部囊性变（Gastric Cystica Profunda，GCP）是一种罕见疾病，其特征为黏膜和/或黏膜下层存在多个囊性病变。通常，GCP 发生于既往接受过手术的胃。如果没有术后病理结果，基于非特异性临床症状和影像学发现，诊断 GCP 具有挑战性。本报告旨在提供迄今为止所有报道的 GCP 病例的全面概述。对 1972 年至 2014 年间所有报道的 GCP 病例进行了全面的文献检索。检索的关键词包括“胃底腺深部囊性变”、“胃黏膜下囊肿”和“异位黏膜下胃腺”。还报告了我们小组的一个回顾性病例，并与现有文献中的病例进行了比较。共发现 52 例病例，其中 37 例（71.2%）为男性，15 例（28.8%）为女性（男女比例=2.5）。患者的平均年龄为 59.9 岁（范围 39-91 岁）。在这些病例中，58.8%（n=30）的病变位于胃体，25.5%（n=13）的病变位于胃底，19.6%（n=9）的病变位于胃窦，3.9%（n=2）的病变位于贲门，1 例位于胃前壁，1 例位于吻合口。其中 52%（n=26）的患者既往接受过胃部手术。GCP 的主要表现包括腹痛（n=14，36.8%）和胃肠道出血（包括呕血和黑便，n=7，18.4%）。52 例患者中仅有 4 例在术前诊断，其余均通过术后组织病理学检查诊断。由于其相对罕见且缺乏典型的临床症状，GCP 术前难以正确诊断。应采用组织病理学检查进行正确诊断。广泛认为完全切除 GCP 是最佳治疗选择。
