Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
World J Gastroenterol. 2024 Feb 21;30(7):673-684. doi: 10.3748/wjg.v30.i7.673.
Gastric cystica profunda (GCP) represents a rare condition characterized by cystic dilation of gastric glands within the mucosal and/or submucosal layers. GCP is often linked to, or may progress into, early gastric cancer (EGC).
To provide a comprehensive evaluation of the endoscopic features of GCP while assessing the efficacy of endoscopic treatment, thereby offering guidance for diagnosis and treatment.
This retrospective study involved 104 patients with GCP who underwent endoscopic resection. Alongside demographic and clinical data, regular patient follow-ups were conducted to assess local recurrence.
Among the 104 patients diagnosed with GCP who underwent endoscopic resection, 12.5% had a history of previous gastric procedures. The primary site predominantly affected was the cardia (38.5%, = 40). GCP commonly exhibited intraluminal growth (99%), regular presentation (74.0%), and ulcerative mucosa (61.5%). The leading endoscopic feature was the mucosal lesion type (59.6%, = 62). The average maximum diameter was 20.9 ± 15.3 mm, with mucosal involvement in 60.6% ( = 63). Procedures lasted 73.9 ± 57.5 min, achieving complete resection in 91.3% ( = 95). Recurrence (4.8%) was managed either surgical intervention ( = 1) or through endoscopic resection ( = 4). Final pathology confirmed that 59.6% of GCP cases were associated with EGC. Univariate analysis indicated that elderly males were more susceptible to GCP associated with EGC. Conversely, multivariate analysis identified lesion morphology and endoscopic features as significant risk factors. Survival analysis demonstrated no statistically significant difference in recurrence between GCP with and without EGC ( = 0.72).
The findings suggested that endoscopic resection might serve as an effective and minimally invasive treatment for GCP with or without EGC.
胃底腺囊(Gastric Cystica Profunda,GCP)是一种罕见的疾病,其特征为胃黏膜和/或黏膜下层的胃腺体囊性扩张。GCP 常与早期胃癌(Early Gastric Cancer,EGC)相关,或可进展为 EGC。
全面评估 GCP 的内镜特征,并评估内镜治疗的疗效,为诊断和治疗提供指导。
本回顾性研究纳入了 104 例行内镜下切除的 GCP 患者。除了人口统计学和临床数据外,还对患者进行了定期随访以评估局部复发情况。
在接受内镜下切除的 104 例 GCP 患者中,12.5%有既往胃手术史。主要受累部位为贲门(38.5%, = 40)。GCP 主要表现为腔内生长(99%, = 40)、规则外观(74.0%, = 40)和溃疡性黏膜(61.5%, = 40)。主要的内镜特征是黏膜病变类型(59.6%, = 40)。平均最大直径为 20.9 ± 15.3 mm,黏膜受累率为 60.6%( = 40)。手术时间为 73.9 ± 57.5 min,完全切除率为 91.3%( = 40)。复发率为 4.8%( = 4),分别通过手术干预( = 1)和内镜下切除( = 4)处理。最终病理证实 59.6%的 GCP 病例与 EGC 相关。单因素分析表明,老年男性更容易发生与 EGC 相关的 GCP。相反,多因素分析确定病变形态和内镜特征是显著的危险因素。生存分析显示,有或无 EGC 的 GCP 复发率无统计学差异( = 0.72)。
研究结果表明,内镜下切除可能是治疗有或无 EGC 的 GCP 的一种有效、微创的方法。