Iwamuro Masaya, Kusumoto Chiaki, Nakagawa Masahiro, Matsueda Kazuhiro, Kobayashi Sayo, Yoshioka Masao, Inaba Tomoki, Toyokawa Tatsuya, Sakaguchi Chihiro, Tanaka Shouichi, Tanaka Takehiro, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan.
Department of Gastroenterology, Nippon Kokan Fukuyama Hospital, Fukuyama, Hiroshima, Japan.
J Gastrointest Oncol. 2023 Apr 29;14(2):554-562. doi: 10.21037/jgo-22-870. Epub 2023 Mar 16.
An oxyntic gland neoplasm confined to the mucosal layer (T1a) is classified as an oxyntic gland adenoma, whereas that with submucosal invasion (T1b) is defined as gastric adenocarcinoma of the fundic gland type (GA-FG).
To reveal the differences in clinical features between them, we retrospectively investigated 136 patients with 150 oxyntic gland adenoma and GA-FG lesions.
The univariate analysis revealed that the mean size (GA-FG oxyntic gland adenoma, 7.7±5.4 5.5±3.1 mm), the prevalence of elevated morphology (79.1% 51.8%), black pigmentation within the lesion (23.9% 9.6%), and non or closed-type atrophy (81.2% 65.1%) were different between the two groups. A multivariate logistic regression analysis revealed that ≥5 mm lesion size (odds ratio, 2.96; 95% confidence interval: 1.21-7.23), elevated morphology (odds ratio, 2.40; 95% confidence interval: 1.06-5.45), and no or closed-type atrophy (odds ratio, 2.49; 95% confidence interval: 1.07-5.80) were factors in distinguishing GA-FG from oxyntic gland adenoma. When oxyntic gland neoplasms with no or one feature were judged as oxyntic gland adenomas and those with two or three features were judged as GA-FG, the sensitivity and specificity were 85.1% and 43.4% for GA-FG, respectively.
We identified three possible distinctive features of GA-FG compared to oxyntic gland adenoma: lesion size ≥5 mm, elevated morphology, and no or closed-type atrophy.
局限于黏膜层（T1a）的胃底腺肿瘤被分类为胃底腺腺瘤，而侵犯黏膜下层（T1b）的则被定义为胃底型腺癌（GA-FG）。
为揭示它们临床特征的差异，我们回顾性研究了136例有150个胃底腺腺瘤和GA-FG病变的患者。
单因素分析显示，两组之间的平均大小（GA-FG 对胃底腺腺瘤，7.7±5.4对5.5±3.1毫米）、隆起形态发生率（79.（1%对51.8%）、病变内黑色素沉着（23.9%对9.6%）以及无或闭合型萎缩（81.2%对65.1%）有所不同。多因素逻辑回归分析显示，病变大小≥5毫米（比值比，2.96；95%置信区间：1.21 - 7.23）、隆起形态（比值比，2.40；95%置信区间：1.06 - 5.45）以及无或闭合型萎缩（比值比，2.49；95%置信区间：1.07 - 5.80）是区分GA-FG与胃底腺腺瘤的因素。当将无或有一个特征的胃底腺肿瘤判定为胃底腺腺瘤，将有两个或三个特征的判定为GA-FG时，GA-FG的敏感性和特异性分别为85.1%和43.4%。
我们确定了与胃底腺腺瘤相比，GA-FG的三个可能的独特特征：病变大小≥5毫米、隆起形态以及无或闭合型萎缩。
