An Early Gastric Cancer Arising on an Fundic Gland Polyp

Abstract Background and study aims Magnifying endoscopy with narrow band imaging (M-NBI) has made a huge contribution to endoscopic diagnosis of early gastric cancer (EGC). However, we sometimes encountered false-negative cases with M-NBI diagnosis (i. e., M-NBI diagnostic limitation lesion: M-NBI-DLL). However, clinicopathological features of M-NBI-DLLs have not been well elucidated. We aimed to clarify the clinicopathological features and histological reasons of M-NBI-DLLs. Patients and methods In this single-center retrospective study, M-NBI-DLLs were extracted from 456 EGCs resected endoscopically at our hospital. We defined histological types of M-NBI-DLLs and analyzed clinicopathologically to clarify histological reasons of M-NBI-DLLs. Results Of 456 EGCs, 48 lesions (10.5 %) of M-NBI-DLLs were enrolled. M-NBI-DLLs was classified into four histological types as follows: gastric adenocarcinoma of fundic-gland type (GA-FG, n = 25), gastric adenocarcinoma of fundic-gland mucosal type (GA-FGM, n = 1), differentiated adenocarcinoma (n = 14), and undifferentiated adenocarcinoma (n = 8). Thirty-nine lesions of M-NBI-DLLs were H. pylori-negative gastric cancers (39/47, 82.9 %). Histological reasons for M-NBI-DLLs were as follows: 1) completely covered with non-neoplastic mucosa (25/25 GA-FG, 8/8 undifferentiated adenocarcinoma); 2) well-differentiated adenocarcinoma with low-grade atypia (1/1 GA-FGM, 14/14 differentiated adenocarcinoma); 3) similarity of surface structure (10/14 differentiated adenocarcinoma); and 4) partially covered and/or mixed with a non-neoplastic mucosa (1/1 GA-FGM, 6/14 differentiated adenocarcinoma). Conclusions Diagnostic limitations of M-NBI depend on four distinct histological characteristics. For accurate diagnosis of M-NBI-DLLs, it may be necessary to fully understand endoscopic features of these lesions using white light imaging and M-NBI based on these histological characteristics and to take a precise biopsy.

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Early gastric cancer in a Helicobacter pylori-negative patient with fundic gland polyps

Progress of Digestive Endoscopy ◽

10.11641/pde.86.1_144 ◽

2015 ◽

Vol 86 (1) ◽

pp. 144-145

Author(s):

Hisashi Hosaka ◽

Misa Iijima ◽

Toshikazu Akiya

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Fundic Gland ◽

Negative Patient ◽

Fundic Gland Polyps

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Feasibility of Plasma-Methylated SFRP2 for Early Detection of Gastric Cancer

Cancer Control ◽

10.1177/1073274820922559 ◽

2020 ◽

Vol 27 (2) ◽

pp. 107327482092255 ◽

Cited By ~ 1

Author(s):

Jin Miao ◽

Yi Liu ◽

Guodong Zhao ◽

Xiaoyu Liu ◽

Yong Ma ◽

...

Keyword(s):

Gastric Cancer ◽

Intestinal Metaplasia ◽

Hyperplastic Polyp ◽

Screening Method ◽

Noninvasive Detection ◽

Fundic Gland ◽

Gastric Intestinal Metaplasia ◽

Fundic Gland Polyp ◽

Serum Cea ◽

Higher Sensitivity

Gastric cancer (GC) is fifth most frequently diagnosed cancer and second leading cause of cancer in China. More than 80% of GC are diagnosed at an advanced stage due to low uptake rate of invasive screening method. The performance of methylated SFRP2 test was evaluated in 236 plasma samples, including 92 patients with GC, 16 intestinal metaplasia patients, 26 gastric fundic gland polyp patients, 13 small adenoma patients, 39 hyperplastic polyp patients, and 50 control patients. The sensitivity of plasma methylated SFRP2 was compared to serum CEA, CA72-4, CA19-9, and CA242 results in 79 patients with GC. The sensitivities for detecting GC and gastric intestinal metaplasia by methylated SFRP2 test were 60.9% and 56.3% with a specificity of 86.0%. Methylated SFRP2 test had significantly higher positive detection rate for patients with GC than gastric fundic gland polyp, small adenoma, and hyperplastic polyp patients. In 79 patients with GC, the sensitivities of CEA, CA72-4, CA19-9, and CA242 for detecting GC were 22.8%, 16.5%, 12.7%, and 11.4%. In comparison, the sensitivity of methylated SFRP2 test for detecting GC was 58.2%. Plasma methylated SFRP2 test may become a valuable tool for the noninvasive detection of GC and precursor lesions and showed higher sensitivity than serum tumor markers.

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A Case of Early Gastric Cancer Following Natural Disappearance of Fundic Gland Polyps

Progress of Digestive Endoscopy(1972) ◽

10.11641/pdensks.50.0_270 ◽

1997 ◽

Vol 50 (0) ◽

pp. 270-271

Author(s):

Tetsuya Sanji ◽

Yasuaki Sakai ◽

Manabu Nishimaki ◽

Yutaka Tani ◽

Syouko Midorikawa ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Fundic Gland ◽

Fundic Gland Polyps

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A Case of Very Well Differentiated Early Gastric Cancer Surrounded by the Fundic Gland Mucosa without Atrophy

Progress of Digestive Endoscopy(1972) ◽

10.11641/pdensks.51.0_182 ◽

1998 ◽

Vol 51 (0) ◽

pp. 182-183

Author(s):

Yusuke Iizuka ◽

Atsushi Mitsunaga ◽

Megumi Uchiyama ◽

Kouji Uchida ◽

Yukihito Nemoto ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Fundic Gland ◽

Well Differentiated

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Endoscopic and Pathological Characteristics of Helicobacter pylori Infection-Negative Early Gastric Cancer

Digestive Diseases ◽

10.1159/000506120 ◽

2020 ◽

Vol 38 (6) ◽

pp. 474-483 ◽

Cited By ~ 1

Author(s):

Taku Mizutani ◽

Hiroshi Araki ◽

Chiemi Saigo ◽

Jun Takada ◽

Masaya Kubota ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Chromogranin A ◽

Pyloric Gland ◽

Fundic Gland ◽

Pepsinogen I ◽

Cardiac Gland ◽

Gland Type ◽

E Cadherin

Background: The characteristics of Helicobacter pylori (HP) infection-negative gastric cancer (HPINGC) have not been well documented because of the rareness. The aim of this study was to classify HPINGC endoscopically and clinicopathologically. Methods: This retrospective study included 1,741 early gastric cancer lesions and evaluated their HP infection status. Expression levels of MUC5AC, MUC6, MUC2, CD10, p53, MIB-1, pepsinogen-I, H+/K+ ATPase, chromogranin A, E-cadherin, and gastrin were evaluated in tumors by immunohistochemistry (IHC). Results: Among the analyzed lesions, 19 (1.1%) were diagnosed as HPINGC and classified into 6 types: undifferentiated (5 lesions), fundic gland (2 lesions), cardiac gland (1 lesion), pyloric gland (3 lesions), foveolar (5 lesions), and mixed (3 lesions) types. Undifferentiated lesions were of pale color, with unclear demarcation and decreased E-cadherin expression. Fundic-type lesions were tan to reddish in color, with submucosal tumor-like protrusions, and positive for pepsinogen-I and H+/K+ ATPase. The cardiac gland type was located in the gastroesophageal junction and was positive for MUC6 and pepsinogen-I. Pyloric gland-type lesions were of the same color as normal mucosa, with mild elevation and unclear demarcation, likely positive for CD10 and chromogranin A. Foveolar epithelial-type lesions were white and elevated, with defined demarcation, and contained MUC5AC-positive cells. Mixed-type lesions, showing various staining patterns in IHC, had both elevated and depressed shape and reddish color. Conclusion: Endoscopic observation and IHC were useful for classifying the characteristics of HPINGC, which may preserve the characteristics of its region of origin.

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