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