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内镜下切除是胃底腺型胃泌酸腺腺瘤或腺癌的合适初始治疗策略。

Endoscopic resection is a suitable initial treatment strategy for oxyntic gland adenoma or gastric adenocarcinoma of the fundic gland type.

机构信息

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.

Department of Gastroenterology, Nippon Kokan Fukuyama Hospital, 1844 Tsunoshita, Daimon-cho, Fukuyama, Hiroshima, 721-0927, Japan.

出版信息

Sci Rep. 2021 Apr 1;11(1):7375. doi: 10.1038/s41598-021-86893-w.

Abstract

The aim of this study was to reveal the histological features of oxyntic gland adenomas and gastric adenocarcinoma of the fundic-gland type (GA-FG). We retrospectively examined the histological features of 126 lesions of oxyntic gland adenoma and/or GA-FG in 116 patients. The prevalence of oxyntic gland adenomas and GA-FG was approximately equal. The majority of the lesions were resected by endoscopic mucosal resection using a diathermic snare (EMR, n = 42) or endoscopic submucosal dissection (ESD, n = 72). Histologically, there were no lesions with invasion at the level of the muscularis propria or deeper, and lymphovascular invasion was present in 1.6%. Of the ESD and EMR specimens, there were no lesions that were positive for vertical margins. Among the eight GA-FG patients with deep (≥ 500 μm) submucosal invasion, six were treated with endoscopic resection alone, and no recurrence was documented. No patients died of the disease during the median follow-up period of 14.5 months. In conclusion, all lesions were confined to the mucosa or submucosa and were negative for vertical margins. Lymphovascular invasion was present in only 1.6% of the patients. Thus, we believe that endoscopic resection is a suitable initial treatment method for oxyntic gland adenoma and GA-FG.

摘要

本研究旨在揭示胃底腺型胃泌素瘤和胃腺癌(GA-FG)的组织学特征。我们回顾性检查了 116 例患者的 126 个胃底腺腺瘤和/或 GA-FG 病变的组织学特征。胃底腺腺瘤和 GA-FG 的患病率大致相等。大多数病变通过热活检圈套切除术(EMR,n=42)或内镜黏膜下剥离术(ESD,n=72)切除。组织学上,没有侵犯固有肌层或更深层的病变,淋巴管血管侵犯率为 1.6%。在 ESD 和 EMR 标本中,没有垂直切缘阳性的病变。在 8 例有深度(≥500μm)黏膜下侵犯的 GA-FG 患者中,6 例仅接受内镜下切除,无复发记录。在中位随访 14.5 个月期间,无患者死于该疾病。总之,所有病变均局限于黏膜或黏膜下层,且垂直切缘阴性。淋巴管血管侵犯率仅为 1.6%。因此,我们认为内镜下切除是胃底腺腺瘤和 GA-FG 的一种合适的初始治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68a6/8016920/5b08ec01cb3a/41598_2021_86893_Fig1_HTML.jpg

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