Department of Endoscopy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka, 818-8502, Japan.
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Clin J Gastroenterol. 2021 Oct;14(5):1337-1343. doi: 10.1007/s12328-021-01443-1. Epub 2021 Jul 22.
A man in his 60s underwent esophagogastroduodenoscopy (EGD) for gastric cancer screening in 2006. A pale, oval, depressed lesion, 8 mm in diameter, was seen in the greater curvature of the gastric antrum. The patient was followed up every 1-2 years. EGD performed 13 years after 2006 showed the lesion with an irregular margin. Histopathological diagnosis of a target biopsy was signet-ring cell carcinoma. The lesion was resected by endoscopic submucosal dissection. The resected specimen was 8 × 3 mm in size, and histopathological examination showed type 0-IIc, signet-ring cell carcinoma, pT1a, Ly0, V0, UL0, pHM0, pVM0. The patient had no history of Helicobacter pylori infection. The serum anti-H. pylori IgG antibody test result and the urea breath test result was negative. Histopathological examination did not reveal the presence of H. pylori. No evidence of atrophic gastritis on endoscopy was found. Based on these findings, the patient was confirmed as not having H. pylori infection. We retrospectively reviewed all previous endoscopic images and confirmed that the lesion was already present in the images taken 17 years ago. To our knowledge, this is the longest retrospective follow-up (17 years) of gastric signet-ring cell carcinoma remaining in the mucosa, without H. pylori infection.
一位 60 多岁的男性因胃癌筛查于 2006 年接受了食管胃十二指肠镜检查（EGD）。在胃窦大弯处可见一个直径 8mm 的苍白、椭圆形、凹陷性病变。患者每 1-2 年进行一次随访。2006 年 13 年后进行的 EGD 显示病变边缘不规则。靶向活检的组织病理学诊断为印戒细胞癌。病变通过内镜黏膜下剥离术切除。切除标本大小为 8×3mm，组织病理学检查显示 0-IIc 型，印戒细胞癌，pT1a，Ly0，V0，UL0，pHM0，pVM0。患者无幽门螺杆菌感染史。血清抗-H. pylori IgG 抗体检测结果和尿素呼气试验结果均为阴性。组织病理学检查未发现 H. pylori。内镜下未发现萎缩性胃炎的证据。根据这些发现，患者被确诊为未感染 H. pylori。我们回顾性地审查了所有以前的内镜图像，并确认该病变在 17 年前拍摄的图像中已经存在。据我们所知，这是胃印戒细胞癌在没有幽门螺杆菌感染的情况下保持在黏膜内最长的回顾性随访（17 年）。
