Christodoulidis Grigorios, Agko Sara E, Kouliou Marina N, Koumarelas Konstantinos E
Department of General Surgery, University Hospital of Larissa, University of Thessaly, Biopolis Campus, Larissa 41110, Greece.
Department of Orthopedic, University Hospital of Larissa, Larissa 41110, Greece.
World J Gastrointest Oncol. 2024 Nov 15;16(11):4321-4325. doi: 10.4251/wjgo.v16.i11.4321.
In this editorial we comment on the article by Xu . Gastric adenocarcinoma (GA) is a malignancy which arises from the gastric mucosa and encompasses heterogenous tumors with varying characteristics. There are two main classifications: Lauren's and the World Health Organization distinguishing the diverse types of GA depending on clinical, genetic, morphological and epidemiological features. "Crawling-type" adenocarcinoma (CRA) is a subtype characterized by irregularly fused glands with low-grade cellular atypia. Moreover, CRA represents differentiated tumor cells resembling intestinal metaplasia which results in misdiagnosis. The diagnosis is of utmost importance, as well as the subclassification and thorough pathological assessment. With regard to the symptoms of GA, these depend on the stage of the disease. Diagnostic methods play a crucial role in assessing the extent of the tumor and the stage of the disease. Nevertheless, early detection of CRA remains challenging due to its histological features. In summary, CRA is a distinct type of GA with particular clinicopathological and histological characteristics. Despite its significance, it not distinguished as a subtype, resulting in diagnostic challenges. Diagnosis is based on careful observation and thorough biopsy analysis, indicating the importance of comprehensive pathological assessment.
在这篇社论中，我们对徐的文章进行评论。胃腺癌（GA）是一种起源于胃黏膜的恶性肿瘤，包括具有不同特征的异质性肿瘤。主要有两种分类：劳伦分类法和世界卫生组织分类法，它们根据临床、遗传、形态学和流行病学特征区分不同类型的胃腺癌。“爬行型”腺癌（CRA）是一种亚型，其特征是腺体不规则融合且细胞异型性低。此外，CRA表现为类似肠化生的分化肿瘤细胞，这导致误诊。诊断至关重要，亚分类和全面的病理评估也同样重要。关于胃腺癌的症状，这些取决于疾病的阶段。诊断方法在评估肿瘤范围和疾病阶段方面起着关键作用。然而，由于其组织学特征，早期检测CRA仍然具有挑战性。总之，CRA是一种具有特殊临床病理和组织学特征的独特类型的胃腺癌。尽管其具有重要意义，但它并未被明确区分为一种亚型，从而导致诊断困难。诊断基于仔细观察和全面的活检分析，这表明了全面病理评估的重要性。
