Endoscopy Center, Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
Endoscopy Center, Anqiu People's Hospital, 159 Xuefu Road, Anqiu, 262100, Shandong, China.
J Gastrointest Cancer. 2023 Jun;54(2):677-681. doi: 10.1007/s12029-022-00812-4. Epub 2022 Mar 19.
Gastric signet ring cell carcinoma is a rare and highly malignant adenocarcinoma, which is characterized by early metastasis, rapid progression and poor prognosis. Several studies have shown that early-stage gastric signet ring cell carcinoma may have equal or better prognosis than other types of gastric cancer. However, most of the early-stage lesions are difficult to detect by endoscopy. We aim to illustrate the difficulty of early detection of gastric signet ring cell carcinoma with mucosal atrophy.
The endoscopic and pathological features of two female cases were analyzed by upper gastrointestinal white light endoscopy combined with narrow-band imaging and endoscopic biopsy.
Two female cases were diagnosed with early-stage gastric signet ring cell carcinoma with atrophic background mucosa occurring in the middle and lower part of the stomach. Both lesions less than 2.0 cm in diameter were surgically removed and identified as intramucosal adenocarcinoma.
We can roughly identify the demarcation of the lesion by combining white light endoscopy and narrow-band imaging, and slightly irregular microsurface and microvascular pattern of the lesion were found via magnifying endoscopic observation, but the demarcation can hardly be accurately identified.
胃印戒细胞癌是一种罕见且高度恶性的腺癌，其特征为早期转移、快速进展和预后不良。多项研究表明，早期胃印戒细胞癌的预后可能与其他类型胃癌相当或更好。然而，大多数早期病变通过内镜难以检测到。我们旨在说明黏膜萎缩对胃印戒细胞癌早期检测的困难。
通过上消化道白光内镜联合窄带成像和内镜活检对两例女性病例的内镜和病理特征进行分析。
两例女性患者均诊断为早期胃印戒细胞癌，伴萎缩性背景黏膜发生于胃中下部。两例直径均小于 2.0cm 的病变均经手术切除并鉴定为黏膜内腺癌。
我们可以通过白光内镜和窄带成像大致识别病变的界限，并且通过放大内镜观察到病变的微表面和微血管形态略有不规则，但难以准确识别病变的界限。
