Department of Gastroenterology, Kobe Red Cross Hospital, Japan.
Department of Gastroenterology, Kobe University Graduate School of Medicine, Japan.
Intern Med. 2023 Oct 1;62(19):2763-2774. doi: 10.2169/internalmedicine.0552-22. Epub 2023 Feb 15.
Objective We explored the clinicopathological characteristics and disease frequency of oxyntic gland neoplasms (OGNs). Methods We retrospectively evaluated the data of patients pathologically diagnosed with OGN at an internal medicine clinic. Patients A total of 13,240 upper gastrointestinal endoscopies were performed on 7,488 patients between December 1, 2017, and March 31, 2021. Results We identified 27 patients with 30 histopathologically confirmed OGNs, yielding a disease frequency of 0.36% (27/7,488). Furthermore, multiple simultaneous lesions were found in 3 of 27 patients (11%). One (3.3%) of the 30 lesions was present in the antrum, whereas the remaining lesions occurred in the body of the stomach. Nine (33%) of the 27 patients had no history of Helicobacter pylori infection, whereas the remaining 18 (67%) were either currently or had been previously infected. Nevertheless, 27/30 lesions (90%) still occurred in non-atrophied regions. After endoscopic treatment, a histopathological examination of the resected specimens revealed submucosal infiltration in 8 (44%) of the 18 lesions; however, none of the lesions showed submucosal desmoplasia. For all patients with submucosal involvement, only observation was performed. There were no recurrent lesions found on follow-up. Conclusion The period prevalence of OGN was 0.36%, which is much higher than previously reported. The discovery of a small submucosal appearing lesion with a faded yellow or white color and dilated microvasculature, especially in a non-atrophic area of the stomach, should raise suspicion for an OGN, which can be endoscopically managed.
探讨胃泌酸腺肿瘤(OGN)的临床病理特征和疾病频率。
我们回顾性评估了 2017 年 12 月 1 日至 2021 年 3 月 31 日期间在一家内科诊所接受病理诊断为 OGN 的患者的数据。
我们共发现 27 例患者存在 30 个经组织病理学证实的 OGN,疾病频率为 0.36%(27/7488)。此外,27 例患者中有 3 例(11%)存在多个同时性病变。30 个病变中有 1 个(3.3%)位于胃窦,其余病变位于胃体。27 例患者中,有 9 例(33%)无幽门螺杆菌感染史,而其余 18 例(67%)为现症或既往感染。然而,27/30 个病变(90%)仍发生在非萎缩区。经内镜治疗后,对切除标本进行组织病理学检查,18 个病变中有 8 个(44%)存在黏膜下浸润;但无病变存在黏膜下纤维组织增生。所有存在黏膜下浸润的患者均仅接受观察,随访中未发现复发病变。
OGN 的现患率为 0.36%,明显高于以往报道。发现胃内小的黏膜下出现的病变,颜色呈淡黄色或白色,微血管扩张,尤其是在胃的非萎缩区,应高度怀疑为 OGN,可通过内镜进行管理。