Division of Gastroenterology, Pusan National University Hospital, Busan, Korea.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Korean J Gastroenterol. 2023 Jun 25;81(6):259-264. doi: 10.4166/kjg.2023.019.
The fundic gland type (GA-FG) of gastric adenocarcinoma is a rare variant of gastric cancer recently included in the 5th edition of the World Health Organization's classification of digestive system tumors. Five patients with GA-FG underwent an endoscopic resection at our institution. None of the patients had a infection. Four lesions were located in the upper third of the stomach, and one was in the lower third. Three lesions had a IIa shape, while two resembled a subepithelial tumor. An endoscopic submucosal dissection was performed in four patients and endoscopic mucosal resection in one. Tumor cells were composed of well-differentiated columnar cells mimicking fundic gland cells, and the median tumor size was 10 mm. Three lesions exhibited submucosal invasion. No lymphatic or venous invasion was observed. Tumor cells were positive for MUC6 in all five cases; one case was focally positive for MUC5AC. No recurrence was observed during a median follow-up period of 13 months. An endoscopic resection can be a safe treatment modality for GA-FG, considering its small size and low risk of recurrence or metastasis.
胃底腺型(GA-FG)胃腺癌是一种罕见的胃癌变体,最近被纳入世界卫生组织第五版消化系统肿瘤分类。我们机构对五名 GA-FG 患者进行了内镜下切除。这些患者均无感染史。四个病变位于胃的上三分之一,一个位于下三分之一。三个病变呈 IIa 型,两个类似黏膜下肿瘤。四名患者接受内镜黏膜下剥离术,一名患者接受内镜黏膜切除术。肿瘤细胞由分化良好的柱状细胞组成,类似于胃底腺细胞,肿瘤的中位大小为 10 毫米。三个病变表现为黏膜下浸润。未见淋巴管或静脉侵犯。所有五例肿瘤细胞均对 MUC6 呈阳性表达;一例 MUC5AC 局灶性阳性。在中位随访 13 个月期间,未观察到复发。考虑到 GA-FG 体积小、复发或转移风险低,内镜下切除可能是一种安全的治疗方式。