GASTRIC ADENOCARCINOMA OF FUNDIC GLAND TYPE: CLINICOPATHOLOGICAL FEATURES DETERMINED BY RETROSPECTIVE ANALYSIS

Abstract BackgroundGastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization’s list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological features of GA-FG using retrospective analyses of endoscopic and pathological findings. Materials and methodsSamples were collected from patients diagnosed with GA-FG. The clinical courses of all patients were monitored prospectively and reviewed retrospectively. Available clinical information, endoscopic features, pathological appearance, and follow-up data were assessed. Immunohistochemistry [mucin (MUC) 2, MUC5, MUC6, P53, CDX2, Ki67, SYN, CD56, CGA, β-catenin, and pepsinogen-I] was examined using Envision two-step method.ResultsEight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 48-80 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, whereas two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~6 mm in diameter (largest, 12 mm). All tumors were localized in the mucosal layer with six cases of invasion into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case.CONCLUSIONGA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.

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Gastric adenocarcinoma of the fundic gland type: clinicopathological features of eight patients treated with endoscopic submucosal dissection

10.21203/rs.3.rs-60985/v3 ◽

2020 ◽

Author(s):

Chengfang Li ◽

Xinglong Wu ◽

Shuang Yang ◽

Xiaorong Yang ◽

Jin Yao ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Gastric Adenocarcinoma ◽

Clinicopathological Features ◽

World Health ◽

Low Grade ◽

Main Body ◽

Fundic Gland ◽

Pepsinogen I ◽

Submucosal Dissection ◽

Gland Type

Abstract Background Gastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization’s list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological features of GA-FG using retrospective analyses of endoscopic and pathological findings. Materials and methods Samples were collected from patients diagnosed with GA-FG. The clinical courses of all patients were monitored prospectively and reviewed retrospectively. Available clinical information, endoscopic features, pathological appearance, and follow-up data were assessed. Immunohistochemistry [mucin (MUC) 2, MUC5, MUC6, P53, CDX2, Ki67, SYN, CD56, CGA, β-catenin, and pepsinogen-I] was examined using Envision two-step method.Results Eight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 48-80 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, whereas two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~6 mm in diameter (largest, 12 mm). The main body of the tumors were localized in the mucosal layer, of which six cases invade into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case.Conclusion GA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.

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Clinicopathological features of early stage gastric adenocarcinoma of fundic gland type

Medicine ◽

10.1097/md.0000000000028469 ◽

2022 ◽

Vol 101 (2) ◽

pp. e28469

Author(s):

Huan Zhang ◽

Shuyan Wang ◽

Yongping Zhang ◽

Fusang Ye ◽

Chunnian Wang

Keyword(s):

Gastric Adenocarcinoma ◽

Early Stage ◽

Clinicopathological Features ◽

Fundic Gland ◽

Gland Type

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Gastric adenocarcinoma of the fundic gland type: clinicopathological features of eight patients treated with endoscopic submucosal dissection

Diagnostic Pathology ◽

10.1186/s13000-020-01047-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Chengfang Li ◽

Xinglong Wu ◽

Shuang Yang ◽

Xiaorong Yang ◽

Jin Yao ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Gastric Adenocarcinoma ◽

Clinicopathological Features ◽

World Health ◽

Low Grade ◽

Main Body ◽

Fundic Gland ◽

Pepsinogen I ◽

Submucosal Dissection ◽

Gland Type

Abstract Background Gastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization’s list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological features of GA-FG using retrospective analyses of endoscopic and pathological findings. Materials and methods Samples were collected from patients diagnosed with GA-FG. The clinical courses of all patients were monitored prospectively and reviewed retrospectively. Available clinical information, endoscopic features, pathological appearance, and follow-up data were assessed. Immunohistochemistry [mucin (MUC) 2, MUC5, MUC6, P53, CDX2, Ki67, SYN, CD56, CGA, β-catenin, and pepsinogen-I] was examined using Envision two-step method. Results Eight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 48 to 80 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, whereas two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~ 6 mm in diameter (largest, 12 mm). The main body of the tumors were localized in the mucosal layer, of which six cases invade into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case. Conclusion GA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.

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Gastric epithelial neoplasm of fundic-gland mucosa lineage: proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type

Journal of Gastroenterology ◽

10.1007/s00535-021-01813-z ◽

2021 ◽

Author(s):

Hiroya Ueyama ◽

Takashi Yao ◽

Yoichi Akazawa ◽

Takuo Hayashi ◽

Koichi Kurahara ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Clinicopathological Features ◽

Low Grade ◽

Fundic Gland ◽

New Classification ◽

Histopathological Classification ◽

Gland Type ◽

Epithelial Neoplasm

Abstract Background Gastric adenocarcinoma of fundic-gland type (GA-FG) is a rare variant of gastric neoplasia. However, the etiology, classification, and clinicopathological features of gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML; generic term of GA-FG related neoplasm) are not fully elucidated. We performed a large, multicenter, retrospective study to establish a new classification and clarify the clinicopathological features of GEN-FGML. Methods One hundred GEN-FGML lesions in 94 patients were collected from 35 institutions between 2008 and 2019. We designed a new histopathological classification of GEN-FGML using immunohistochemical analysis and analyzed via clinicopathological, immunohistochemical, and genetic evaluation. Results GEN-FGML was classified into 3 major types; oxyntic gland adenoma (OGA), GA-FG, and gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM). In addition, GA-FGM was classified into 3 subtypes; Type 1 (organized with exposure type), Type 2 (disorganized with exposure type), and Type 3 (disorganized with non-exposure type). OGA and GA-FG demonstrated low-grade epithelial neoplasm, and GA-FGM should be categorized as an aggressive variant of GEN-FGML that demonstrated high-grade epithelial neoplasm (Type 2 > 1, 3). The frequent presence of GNAS mutation was a characteristic genetic feature of GEN-FGML (7/34, 20.6%; OGA 1/3, 33.3%; GA-FG 3/24, 12.5%; GA-FGM 3/7, 42.9%) in mutation analysis using next-generation sequencing. Conclusions We have established a new histopathological classification of GEN-FGML and propose a new lineage of gastric epithelial neoplasm that harbors recurrent GNAS mutation. This classification will be useful to estimate the malignant potential of GEN-FGML and establish an appropriate standard therapeutic approach.

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Gastric adenocarcinoma of fundic gland type: Endoscopic and clinicopathological features

World Journal of Gastrointestinal Endoscopy ◽

10.4253/wjge.v8.i4.244 ◽

2016 ◽

Vol 8 (4) ◽

pp. 244 ◽

Cited By ~ 6

Author(s):

Gen Tohda

Keyword(s):

Gastric Adenocarcinoma ◽

Clinicopathological Features ◽

Fundic Gland ◽

Gland Type

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Sa1267 ENDOSCOPIC AND CLINICOPATHOLOGICAL FEATURES OF GASTRIC ADENOCARCINOMA OF THE FUNDIC GLAND TYPE

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.305 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB188-AB189

Author(s):

Masaki Miyazawa ◽

Mitsuru Matsuda ◽

Katsuhisa Inamura ◽

Uichiro Fuchizaki ◽

Takashi Kagaya ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Clinicopathological Features ◽

Fundic Gland ◽

Gland Type

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Gastric Adenocarcinoma of the Fundic Gland Type: Clinicopathological Features of Eight Patients Treated With Endoscopic Submucosal Dissection

10.21203/rs.3.rs-60985/v1 ◽

2020 ◽

Author(s):

Chengfang Li ◽

Xinglong Wu ◽

Shuang Yang ◽

Xiaorong Yang ◽

Jin Yao ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Gastric Adenocarcinoma ◽

Narrow Band Imaging ◽

Clinicopathological Features ◽

World Health ◽

Low Grade ◽

Fundic Gland ◽

Submucosal Dissection ◽

Elevated Type ◽

Gland Type

Abstract BACKGROUNDGastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization’s list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological features of GA-FG using retrospective analyses of endoscopic and pathological findings. CASE SUMMARYEight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 4880 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, while two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~6 mm in diameter (largest, 12 mm). All tumors were localized in the mucosal layer with six cases of invasion into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case.CONCLUSIONGA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.

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