scholarly journals Gastric adenocarcinoma of the fundic gland: A review of clinicopathological characteristics, treatment and prognosis

Rare Tumors ◽  
2021 ◽  
Vol 13 ◽  
pp. 203636132110601
Author(s):  
Xiang-yu Meng ◽  
Guang Yang ◽  
Cheng-ji Dong ◽  
Ru-yi Zheng
Keyword(s):  
Tumor Cells ◽  
Gastric Adenocarcinoma ◽  
Vascular Invasion ◽  
Tumor Volume ◽  
Clinicopathological Characteristics ◽  
Tubular Adenocarcinoma ◽  
Fundic Gland ◽  
Favorable Prognosis ◽  
Poorly Differentiated ◽  
Well Differentiated

Gastric adenocarcinoma of the fundic gland is a rare, well-differentiated gastric cancer entity, and very few patients transition to poorly differentiated tubular adenocarcinoma during progression. Gastric adenocarcinoma of the fundic gland originates from the mucosa of the gastric fundic gland, usually without chronic gastritis or intestinal metaplasia. Histologically, the tumor cells are closely arranged to form anastomosing tubular glands, and more than 95% of tumor cells differentiate towards chief cells. Most gastric adenocarcinoma of the fundic gland cases are characterized by submucosal involvement, but the tumor volume is usually small, with lymphatic and vascular invasion rarely observed. Therefore, endoscopic submucosal dissection can be an ideal treatment, leading to a favorable prognosis, and recurrence and metastasis of the disease are uncommon.

HER2 OVEREXPRESSION IN ENDOSCOPIC BIOPSY SAMPLE OF GASTRIC ADENOCARCINOMA BY IMMUNOHISTOCHEMISTRY

2012 ◽  
pp. 109-118
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta
Keyword(s):  
Gastric Adenocarcinoma ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Endoscopic Biopsy ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Well Differentiated

Background and aim: HER2 overexpression by immunohistochemistry is a prognostic maker in gastric cancer and helps to select candidates benefitted from targeted therapy with trastuzumab. This study is aimed at the assessing HER2 overexpression and its relationship with endoscopic and histopathological findings of gastric adenocarcinoma. Objectives and methods: Biopsy samples from 92 gastric cancer patients were examined for HER2 status by immunohistochemical staining. Results: 6.5% of tumors were cardia tumors and 93.5% were non-cardia tumors. Using the Lauren classification, 51.1% were intestinal type and 48.9% were diffuse type. Using WHO classification, 54.3% were tubular adenocarcinoma, 7.6% were mucinous adenocarcinoma, 15.2% were signet-ring cell carcinoma, and 22.8% were undifferentiated carcinoma. 32.6% were well-differentiated, 15.2% were moderately-differentiated, and 52.2% were poorly-differentiated carcinoma. HER2 was positive in 20.7% of gastric carcinomas, 50% cardia tumors and 18.6% non-cardia tumors. HER2 positivity among polypoid, fungating, ulcerated, and infiltrative types were 38.5%, 29.7%, 9.1% and 0%, respectively. HER2 overexpression in intestinal type was higher than that in diffuse type (31.9% vs. 8.9%, p = 0.009). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 28.0%, 14.3%, 7.1% and 14.3%, respectively. HER2 overexpressions were different between differentiation degrees: 30% of well-differentiated tumors, 35.7% moderately-differentiated tumors, and 10.4% of poorly-differentiated tumors (p = 0.037). Conclusions: HER2 overexpression was found in 20.7% of endoscopic biopsy sample of gastric adenocarcinoma and was associated with endoscopic gross characteristic, Lauren histologic type and differentiation degree.

scholarly journals Clinicopathological and Endoscopic Features of Raspberry-Shaped Gastric Cancer in Helicobacter pylori-Uninfected Patients

Digestion ◽  
2020 ◽  
pp. 1-8
Author(s):  
Noboru Yatagai ◽  
Hiroya Ueyama ◽  
Muneo Ikemura ◽  
Ryota Uchida ◽  
Hisanori Utsunomiya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Submucosal Tumor ◽  
Clinicopathological Characteristics ◽  
Fundic Gland ◽  
Histopathological Classification ◽  
Histological Characteristics ◽  
Greater Curvature ◽  
H Pylori ◽  
Tumor Shape

<b><i>Background:</i></b> Gastric adenocarcinoma of foveolar type (GA-FV) is a raspberry-shaped gastric cancer (RSGC) and garners much attention as <i>H. pylori</i> (<i>Hp</i>)-uninfected gastric cancer. However, the classification and clinicopathological and endoscopic features of RSGCs in <i>Hp</i>-uninfected patients are poorly defined. We designed a new histopathological classification of RSGC and compared them via endoscopic and clinicopathological characteristics. <b><i>Summary:</i></b> From 996 patients with early gastric cancers resected by endoscopy in our hospital, we studied 24 RSGC lesions from 21 (2.4%) <i>Hp</i>-uninfected patients. RSGCs were classified into 3 histological types as follows: GA-FV (<i>n</i> = 19), gastric adenocarcinoma of fundic gland type (GA-FG, <i>n</i> = 2), and gastric adenocarcinoma of fundic gland mucosa type (GA-FGM, <i>n</i> = 3). Most of the lesions were found at the greater curvature of the upper or middle third of the stomach. GA-FV lesions were homogeneously reddish and frequently accompanied with a whitish area around the tumor and an irregular microvascular (MV) pattern; these features were confirmed histopathologically by the presence of homogeneous neoplastic foveolar epithelium with foveolar hyperplasia around the tumors. GA-FG lesions might be heterogeneously reddish with a submucosal tumor shape and regular MV pattern; these were confirmed by the presence of covered or mixed nonneoplastic epithelium on deeper regions of tumors. GA-FGM lesions might be homogeneously reddish and occasionally had a submucosal tumor shape and irregular MV pattern; these were confirmed by the presence of homogeneous neoplastic foveolar epithelium on deeper regions of the tumors. <b><i>Key Messages:</i></b> RSGCs in <i>Hp</i>-uninfected patients are classified into 3 histopathological types. For accurate diagnosis of RSGCs, it may be necessary to fully understand endoscopic features of these lesions based on these histological characteristics and to take a precise biopsy.

scholarly journals Factors affecting overall survival in ductal adenocarcinoma of the pancreatic head. Experience of one center

2021 ◽  
Vol 11 (1) ◽  
pp. 20-28
Author(s):  
D.  M. Kuchin ◽  
Ya.  I. Kolesnik ◽  
H.  G. Torgomyan ◽  
V.  E. Zagainov
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Vascular Invasion ◽  
Survival Rates ◽  
Pancreatic Head ◽  
Ductal Adenocarcinoma ◽  
Factors Affecting ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Major Factors

Purpose. To identify major factors affecting the overall survival (OS). To select the cohort of patients with the best prognosis.Materials and methods. A retrospective analysis included data of 268 patients, 128 men and 140 women, with median age of 59±10,53 (30 to 83) years. For multivariate analysis of survival, patients were selected who underwent pancreaticoduodenectomy (PD) for ductal adenocarcinoma of the pancreatic head.Results. Our study demonstrated that histologically verified vascular invasion (detected only in 30 % of patients who underwent PD with resection of the major vessels) statistically significantly affected the OS. The increased CA19-9 level over 500 U / L (detected in 32,3 % of cases) is the factor that significantly worsens the OS. Patients with high grade adenocarcinoma have significantly better survival rates compared with patients who have moderately or poorly differentiated adenocarcinoma (p = 0.014; median 26 months, 95 % CI 4.4–47.6 versus median 17 months, 95 % CI 15–19, an median: 13 months, 95 % CI 5–21, respectively). Also, the use of adjuvant chemotherapy has a positive effect on long-term outcomes (p = 0.0001; median 26 months, 95 % CI 21.7–30.3 versus median 13 months, 95 % CI 11.3–14.7).Conclusion. A well-differentiated tumor and the use of adjuvant chemotherapy significantly increase the OS of patients. Poorly differentiated tumor, CA19-9 level over 500 U / mL and the histologically confirmed vascular invasion significantly worsen the prognosis of these patients.

scholarly journals Pathological grading for predicting metastasis in phaeochromocytoma and paraganglioma

2014 ◽  
Vol 21 (3) ◽  
pp. 405-414 ◽  
Author(s):  
Noriko Kimura ◽  
Ryoichi Takayanagi ◽  
Nae Takizawa ◽  
Eiji Itagaki ◽  
Takayuki Katabami ◽  
...  
Keyword(s):  
Vascular Invasion ◽  
Significant Negative Correlation ◽  
Initial Operation ◽  
Dehydrogenase Gene ◽  
Prediction Of Metastasis ◽  
Poorly Differentiated ◽  
The Mean ◽  
Well Differentiated ◽  
Benign Tumours ◽  
Subunit B

Phaeochromocytomas (PHEO) and paragangliomas are rare catecholamine-producing tumours. Although 10–30% of these tumours metastasise, histopathological criteria to discriminate malignant from benign tumours have not been established; therefore, reliable histopathological markers predicting metastasis are urgently required. A total of 163 tumours, including 40 metastatic tumours, collected by the Phaeochromocytoma Study Group in Japan (PHEO-J) were analysed using a system called grading system for adrenal phaeochromocytoma and paraganglioma (GAPP). The tumours were scored based on GAPP criteria as follows: histological pattern, cellularity, comedo-type necrosis, capsular/vascular invasion, Ki67 labelling index and catecholamine type. All tumours were scored from 0 to 10 points and were graded as one of the three types: well-differentiated (WD, 0–2 points), moderately differentiated (MD, 3–6 points) and poorly differentiated (PD, 7–10 points). GAPP scores of the non-metastatic and metastatic groups were 2.08±0.17 and 5.33±0.43 (mean±s.e.m., P<0.001) respectively. There was a significant negative correlation between the GAPP score and the interval until metastasis (r=−0.438, P<0.01). The mean number of years until metastasis after the initial operation was 5.5±2.6 years. The study included 111 WD, 35 MD and 17 PD types. The five-year survival of these groups was 100, 66.8 and 22.4% respectively. In addition, negative immunoreactivity for succinate dehydrogenase gene subunit B (SDHB) was observed in 13 (8%) MD or PD tumours and ten of the 13 (77%) had metastases. Our data indicate that a combination of GAPP classification and SDHB immunohistochemistry might be useful for the prediction of metastasis in these tumours.

RELATIONSHIP BETWEEN ENDOSCOPIC PROPERTIES, HISTOPATHOLOGY AND HER2 OVEREXPRESSION IN GASTRIC ADENOCARCINOMA

2011 ◽  
pp. 21-29
Author(s):  
Viet Nho Le ◽  
Van Huy Tran ◽  
Cong Thuan Dang ◽  
Van To Ta
Keyword(s):  
Gastric Cancer ◽  
Undifferentiated Carcinoma ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
Her2 Overexpression ◽  
Tubular Adenocarcinoma ◽  
Signet Ring ◽  
Poorly Differentiated ◽  
Ring Cell ◽  
Well Differentiated

Objective: HER2 may have a prognostic value in gastric cancer and test for HER2 overexpression help to select the patients for the targeted therapy with trastuzumab. Our aim was to study endoscopic properties, histopathology of gastric adenocarcinoma and their relationship with HER2 overexpression. Materials and Methods: Between 3/2010 and 05/2011, 64 patients with gastric cancer were tested for HER2 status by immunohistochemical staining of formalin-fixed paraffin-embedded endoscopic biopsy samples. Design: Cross-sectional study. Results: According to Borrmann, polypoid, fungating, ulcerated, and infiltrative type cancer. According to Lauren’s classification, 42.2% were intestinal, 57.8% were diffuse. According to WHO, 43.8% were tubular adenocarcinoma, 7.8% were mucinous adenocarcinoma, 17.2% were signet-ring cell carcinoma, and 31.3% were undifferentiated carcinoma. 29.7% were well-differentiated tumors, 18.8% were moderately-differentiated tumors, and 51.6% were poorly-differentiated tumors. HER2 overexpression was present in 23.5% of gastric carcinomas. 40% cardia tumors and 22% non-cardia tumors were HER2 positive. HER2 overexpressions were different between polypoid, fungating, ulcerated, and infiltrative types with rate of 30.8%, 37%, 6.3% and 0%, respectively (p = 0.04). HER2 overexpression of intestinal type tumors was higher than diffuse type tumors (37% vs 13.5%, p=0.04). HER2 overexpression in tubular adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma, and undifferentiated carcinoma was 35.7%, 9.1%, 20% and 15%, respectively. 36.8% of well-differentiated tumors, 33.3% moderately-differentiated tumors, and 12.1% of poorly-differentiated tumors overexpress HER2. Conclusions: HER2 overexpression was found in 23.5% of gastric carcinomas and was associated to endoscopic properties, histopathologic type of tumors. Keywords: HER2, gastric cancer.

scholarly journals Gastric Adenocarcinoma of the Fundic Gland Type Treated by Endoscopic Mucosal Resection: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Eleanor Lewin ◽  
Philip Daroca ◽  
Sanjay Sikka ◽  
Tong Wu ◽  
Yukihiro Nakanishi
Keyword(s):  
Gastric Adenocarcinoma ◽  
Polypoid Lesion ◽  
Lymphatic Invasion ◽  
Gastric Fundus ◽  
Fundic Gland ◽  
Muscularis Mucosae ◽  
Invasive Potential ◽  
Complete Disruption ◽  
Well Differentiated ◽  
Gland Type

Gastric adenocarcinoma of the fundic gland type (GA-FG) is a rare entity that has only recently been described and defined. There is ongoing controversy regarding the malignant potential of this lesion. We report the case of a GA-FG in a 49-year-old Caucasian man who was referred to endoscopy for management of an incidentally found gastric polyp. Endoscopy showed a single polypoid lesion in the gastric fundus which was successfully removed with endoscopic resection. Grossly, the polyp measured 1.1 cm in greatest dimension. Microscopic examination showed irregularly branched neoplastic glands covered with a nonneoplastic foveolar epithelium. The continuity between the neoplastic glands and the fundic glands is clearly identified, indicating the tumor arose from the fundic glands. The tumor cells exhibited occasional oxyntic cytoplasm with enlarged atypical nuclei. The tumor invaded the submucosa with complete disruption of the muscularis mucosae and mild lymphocytic and fibroblastic stromal reaction. No necrosis, mitosis, or lymph-vascular invasion was identified. Although some authors have proposed reclassification of GA-FGs as oxyntic gland polyps/adenomas, in light of several reported cases with submucosal invasion as well as lymphatic invasion, we maintain that this neoplasm is best categorized as an extremely well-differentiated adenocarcinoma to reflect its invasive potential.

scholarly journals Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1247
Author(s):  
Tiziana Feola ◽  
Roberta Centello ◽  
Franz Sesti ◽  
Giulia Puliani ◽  
Monica Verrico ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peptide Receptor Radionuclide Therapy ◽  
Progression Free Survival ◽  
Large Cell ◽  
Clinicopathological Characteristics ◽  
Proliferation Index ◽  
Cochrane Library ◽  
Neuroendocrine Neoplasms ◽  
Poorly Differentiated ◽  
Well Differentiated

Background: Highly proliferative (G3) neuroendocrine neoplasms are divided into well differentiated tumors (NETs) and poorly differentiated carcinomas (NECs), based on the morphological appearance. This systematic review aims to evaluate the clinicopathological features and the treatment response of the NEC subgroup with a Ki67 labeling index (LI) < 55%. Methods: A literature search was performed using MEDLINE, Cochrane Library, and Scopus between December 2019 and April 2020, last update in October 2020. We included studies reporting data on the clinicopathological characteristics, survival, and/or therapy efficacy of patients with NECs, in which the Ki67 LI was specified. Results: 8 papers were included, on a total of 268 NEC affected patients. NECs with a Ki67 LI < 55% have been reported in patients of both sexes, mainly of sixth decade, pancreatic origin, and large-cell morphology. The prevalent treatment choice was chemotherapy, followed by surgery and, in only one study, peptide receptor radionuclide therapy. The subgroup of patients with NEC with a Ki67 LI < 55% showed longer overall survival and progression free survival and higher response rates than the subgroup of patients with a tumor with higher Ki67 LI (≥55%). Conclusions: NECs are heterogeneous tumors. The subgroup with a Ki67 LI < 55% has a better prognosis and should be treated and monitored differently from NECs with a Ki67 LI ≥ 55%.

scholarly journals IMP3 protein is an independent prognostic factor of clinical stage II rectal cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniela Bevanda Glibo ◽  
Danijel Bevanda ◽  
Katarina Vukojević ◽  
Snježana Tomić
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Vascular Invasion ◽  
Clinical Stage ◽  
Stage Ii ◽  
Disease Relapse ◽  
Free Interval ◽  
Risk Of Disease ◽  
Poorly Differentiated ◽  
Well Differentiated

AbstractImmunohistochemical level of IMP3-protein in patients with rectal cancer in clinical stage II (141), were correlated with sociodemographic, pathohistological and clinical indicators and duration of overall-survival and progression-free-survival. Vascular invasion was associated with IMP3-positive immunostaining (p < 0.001). Vascular invasion ratio in the group of poorly-differentiated-tumors was 21 times higher than in the group of well-differentiated-tumors. IMP3-positive patients lived 2.2 times shorter than negative (p < 0.001). Patients with well-differentiated-tumors lived 1.7 times longer than the subjects with poorly-differentiated-tumors (p < 0.001). Patients without vascular invasion lived 2.7 times longer than the subjects with vascular invasion (p < 0.001). The risk of mortality was 2.3 times higher for IMP3 positive patients (p = 0.027) and 10.4 higher for the patients with vascular invasion (p < 0.001). IMP3-negative participants had 2.3 times longer free interval without disease (p < 0.001). The free interval without disease was 3.6 times longer in the group without vascular invasion (p < 0.001). The risk of disease relapse in the IMP3 positive group was 5.3 times higher (p < 0.001) and with vascular invasion was 8 times longer (p < 0.001). The risk of disease relapse was 6.8 times higher in the group with vascular invasion (p < 0.001). Patients with rectal cancer and high IMP3-protein level will have a shorter overall survival relative to patients without or with low levels of IMP3. The analysis of IMP3 expression by immunohistochemistry pointed IMP3 as an independent prognostic factor of clinical stage II rectal cancer.

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