Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pathology, Central Draft Physical Examination Office, Military Manpower Administration, Daegu, Korea.
J Gastric Cancer. 2024 Oct;24(4):378-390. doi: 10.5230/jgc.2024.24.e30.
Oxyntic gland neoplasm (OGN) is a rare condition that can be classified as oxyntic gland adenoma (OGA) or gastric adenocarcinoma of fundic-gland type (GA-FG). GA-FG primarily presents as early gastric cancer, with only a few reported cases of advanced gastric cancer (AGC). We aimed to investigate the clinicopathological features of OGN and describe an aggressive variant.
We investigated a total of 29 cases, including a patient with double primary cases, diagnosed with OGN or differentiated-type adenocarcinoma with GA-FG morphology, between November 2016 and April 2022. We analyzed 54 pathological specimens and reviewed their clinicopathological, endoscopic, and histological features. The lesions were reclassified as OGA or GA-FG, and immunohistochemical (IHC) staining for MUC-5AC and MUC-6 was performed on available resected GA-FG cases.
The median patient age was 65 years and males accounted for 58.6% of patients. Most cases occurred in the body horizontally (69.0%) and on the greater curvature side cross-sectionally (48.3%). Endoscopically, type 0-IIa (41.4%) and a subepithelial tumor-like appearance (24.1%) were the most common findings. Histologically, there were 8 cases of OGA (27.6%) and 21 cases of GA-FG (72.4%). In GA-FG, MUC-6 was positive in 13 cases (81.3%), whereas MUC-5AC was positive in 8 cases (50.0%). Three cases presented as AGCs.
Although OGNs are generally considered low-grade, they can present as AGCs and may exhibit features of lymphovascular or perineural invasion. Recognizing the clinicopathological features and accurately diagnosing OGN are important for providing adequate treatment.
胃底腺肿瘤（OGN）是一种罕见的疾病，可分为胃底腺腺瘤（OGA）或胃底腺型胃腺癌（GA-FG）。GA-FG 主要表现为早期胃癌，仅有少数晚期胃癌（AGC）的报道。我们旨在研究 OGN 的临床病理特征，并描述一种侵袭性变异型。
我们共研究了 29 例病例，包括 1 例双原发病例，这些病例被诊断为 OGN 或具有 GA-FG 形态的分化型腺癌。研究时间为 2016 年 11 月至 2022 年 4 月。我们分析了 54 例病理标本，并回顾了其临床病理、内镜和组织学特征。病变被重新分类为 OGA 或 GA-FG，并对可获得的 GA-FG 切除标本进行了 MUC-5AC 和 MUC-6 的免疫组织化学（IHC）染色。
患者的中位年龄为 65 岁，男性占 58.6%。大多数病例发生在胃体的水平位（69.0%）和胃大弯侧的横切位（48.3%）。内镜下，0-IIa 型（41.4%）和黏膜下肿瘤样表现（24.1%）最常见。组织学上，有 8 例 OGA（27.6%）和 21 例 GA-FG（72.4%）。在 GA-FG 中，MUC-6 阳性的有 13 例（81.3%），MUC-5AC 阳性的有 8 例（50.0%）。有 3 例表现为 AGC。
尽管 OGN 通常被认为是低级别肿瘤，但它们也可以表现为 AGC，并可能具有淋巴管或神经周围侵犯的特征。认识到 OGN 的临床病理特征并准确诊断 OGN 对于提供适当的治疗非常重要。
