Gastric adenocarcinoma of the fundic gland(chief cellpredominant type, GA-FG-CCP) is a rare variant of welldifferentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from t...Gastric adenocarcinoma of the fundic gland(chief cellpredominant type, GA-FG-CCP) is a rare variant of welldifferentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from the gastric mucosa of the fundic gland region without chronic gastritis or intestinal metaplasia. The majority of GA-FG-CCPs exhibit either a submucosal tumor-like superficial elevated shape or a flat shape on macroscopic examination. Narrow-band imaging with endoscopic magnification may reveal a regular or an irregular microvascular pattern, depending on the degree of tumor exposure to the mucosal surface. Pathological analysis of GA-FG-CCPs is characterized by a high frequency of submucosal invasion, rare occurrences of lymphatic and venous invasion, and low-grade malignancy. Detection of diffuse positivity for pepsinogen-I by immunohistochemistry is specific for GA-FG-CCP. Careful endoscopic examination and detailed pathological evaluation are essential for early and accurate diagnosis of GA-FG-CCP. Nearly all GA-FG-CCPs are treated by endoscopic resection due to their small tumor size and low risk of recurrence or metastasis.展开更多
Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper ...Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.展开更多
Objective： To study the regulative action of mica monomer powder preparation on the chief and parietal cells as well as G and D cells in the gastric mucosa of the experimental atrophic gastritis （CAG） rats. Methods...Objective： To study the regulative action of mica monomer powder preparation on the chief and parietal cells as well as G and D cells in the gastric mucosa of the experimental atrophic gastritis （CAG） rats. Methods： Intervention therapy was given to the experimental CAG rats at three different doses of mica monomer powder preparation to evaluate the changes of chief and parietal cells as well as G and D cells in the gastric mucosa and the histopathological changes of gastric mucosa. Results： Mica monomer powder preparation at three different doses could increase the amount of chief and parietal cells as well as G and D cells in gastric mucosa of the experimental CAG rats and alleviate and control the inflammation of gastric mucosa and the atrophy of gastric mucosa glands. Especially, better effects were shown in the mid and high dose groups. Conclusion： Mica has the pharmacological action of protecting the gastric mucosa, promoting the regeneration of gastric glands, enhancing blood flow of the gastric mucosa, and consequently improving the inflammatory responses of the gastric mucosa. One of the mechanisms is associated with promoting the secretion of gastric acid and gastric pepsin and regulating the neuroendocrine mechanism including gut hormone secretion （gastrin and somatostatin） by increasing the number of chief and parietal cells as well as G and D cells.展开更多
Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical ...Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features.A new and rare variant of gastric adenocarcinoma with chief cell differentiation(GA-CCD)has recently been recognized.Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GACCD.Typically,GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus.Histologically,this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells.Immunohistochemically,GA-CCD is diffusely positive for mucin(MUC)6 and negative for MUC2and MUC5AC.However,other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude.Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp,comprehensive assessment and observation by an endoscopist are strongly recommended.Herein,we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.展开更多
目的探讨主细胞为主型胃底腺型胃癌(gastric adenocarcinoma of fundic gland type of chief cell predominant type,GA-FG-CCP)的临床、内镜与病理学特征、治疗及预后。方法收集2018年1月—2023年5月在宁波市医疗中心李惠利医院和上海...目的探讨主细胞为主型胃底腺型胃癌(gastric adenocarcinoma of fundic gland type of chief cell predominant type,GA-FG-CCP)的临床、内镜与病理学特征、治疗及预后。方法收集2018年1月—2023年5月在宁波市医疗中心李惠利医院和上海市东方医院经病理组织学诊断为GA-FG-CCP的40例患者(41个病变)资料,分析其临床及内镜特征、病理学特征、免疫组化结果、内镜治疗、预后情况。结果40例GA-FG-CCP患者中,男15例、女25例,平均年龄60.03岁,临床上多无明显不适症状,均无肿瘤家族史。除1例外,其余均无幽门螺杆菌感染。白光观察的内镜特征:①主要位于胃体上部(63.41%,26/41);②褪色/白色调(56.10%,23/41);③扩张的树枝状血管(78.05%,32/41);④背景黏膜无萎缩改变(100.00%,41/41)。窄带光成像放大观察:①无明显边界(85.37%,35/41);②腺窝开口部扩大(87.80%,36/41);③窝间部增宽(92.68%,38/41);④缺乏不规则的微血管结构(95.12%,39/41)。患者活检标本病理均证实为胃底腺型肿瘤。肿瘤主要由异型程度低、类似主细胞分化的细胞组成,但也有散在壁细胞,多呈不规则、融合性生长的腺管。40例患者中20例未接受内镜治疗。接受内镜切除治疗的20例21个病变中,12个浸润至黏膜下层(20~520µm),9个为黏膜内癌。无淋巴管及血管浸润,水平及垂直切缘阴性。免疫组化染色结果:胃蛋白酶原Ⅰ和MUC6阳性,H+-K+-ATPase散在少数阳性,Ki-67肿瘤细胞增殖指数低,MUC5AC、MUC2和CD10均阴性。患者平均随访15.85个月,期间均无复发或转移。结论GA-FG-CCP是一种分化非常好的罕见肿瘤类型,临床症状不明显,但内镜下有特征性表现,应用白光和窄带光成像放大观察可提高检出率,病理和免疫组化染色可明确诊断。展开更多
文摘Gastric adenocarcinoma of the fundic gland(chief cellpredominant type, GA-FG-CCP) is a rare variant of welldifferentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from the gastric mucosa of the fundic gland region without chronic gastritis or intestinal metaplasia. The majority of GA-FG-CCPs exhibit either a submucosal tumor-like superficial elevated shape or a flat shape on macroscopic examination. Narrow-band imaging with endoscopic magnification may reveal a regular or an irregular microvascular pattern, depending on the degree of tumor exposure to the mucosal surface. Pathological analysis of GA-FG-CCPs is characterized by a high frequency of submucosal invasion, rare occurrences of lymphatic and venous invasion, and low-grade malignancy. Detection of diffuse positivity for pepsinogen-I by immunohistochemistry is specific for GA-FG-CCP. Careful endoscopic examination and detailed pathological evaluation are essential for early and accurate diagnosis of GA-FG-CCP. Nearly all GA-FG-CCPs are treated by endoscopic resection due to their small tumor size and low risk of recurrence or metastasis.
文摘Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.
基金the Postdoctoral Scientific Foundation of China(No.2002032232)the Natural Science Foundation of Science and Technology Office of Zhejiang Province(No.G20011025)
文摘Objective： To study the regulative action of mica monomer powder preparation on the chief and parietal cells as well as G and D cells in the gastric mucosa of the experimental atrophic gastritis （CAG） rats. Methods： Intervention therapy was given to the experimental CAG rats at three different doses of mica monomer powder preparation to evaluate the changes of chief and parietal cells as well as G and D cells in the gastric mucosa and the histopathological changes of gastric mucosa. Results： Mica monomer powder preparation at three different doses could increase the amount of chief and parietal cells as well as G and D cells in gastric mucosa of the experimental CAG rats and alleviate and control the inflammation of gastric mucosa and the atrophy of gastric mucosa glands. Especially, better effects were shown in the mid and high dose groups. Conclusion： Mica has the pharmacological action of protecting the gastric mucosa, promoting the regeneration of gastric glands, enhancing blood flow of the gastric mucosa, and consequently improving the inflammatory responses of the gastric mucosa. One of the mechanisms is associated with promoting the secretion of gastric acid and gastric pepsin and regulating the neuroendocrine mechanism including gut hormone secretion （gastrin and somatostatin） by increasing the number of chief and parietal cells as well as G and D cells.
文摘Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features.A new and rare variant of gastric adenocarcinoma with chief cell differentiation(GA-CCD)has recently been recognized.Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GACCD.Typically,GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus.Histologically,this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells.Immunohistochemically,GA-CCD is diffusely positive for mucin(MUC)6 and negative for MUC2and MUC5AC.However,other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude.Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp,comprehensive assessment and observation by an endoscopist are strongly recommended.Herein,we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.
文摘目的探讨主细胞为主型胃底腺型胃癌(gastric adenocarcinoma of fundic gland type of chief cell predominant type,GA-FG-CCP)的临床、内镜与病理学特征、治疗及预后。方法收集2018年1月—2023年5月在宁波市医疗中心李惠利医院和上海市东方医院经病理组织学诊断为GA-FG-CCP的40例患者(41个病变)资料,分析其临床及内镜特征、病理学特征、免疫组化结果、内镜治疗、预后情况。结果40例GA-FG-CCP患者中,男15例、女25例,平均年龄60.03岁,临床上多无明显不适症状,均无肿瘤家族史。除1例外,其余均无幽门螺杆菌感染。白光观察的内镜特征:①主要位于胃体上部(63.41%,26/41);②褪色/白色调(56.10%,23/41);③扩张的树枝状血管(78.05%,32/41);④背景黏膜无萎缩改变(100.00%,41/41)。窄带光成像放大观察:①无明显边界(85.37%,35/41);②腺窝开口部扩大(87.80%,36/41);③窝间部增宽(92.68%,38/41);④缺乏不规则的微血管结构(95.12%,39/41)。患者活检标本病理均证实为胃底腺型肿瘤。肿瘤主要由异型程度低、类似主细胞分化的细胞组成,但也有散在壁细胞,多呈不规则、融合性生长的腺管。40例患者中20例未接受内镜治疗。接受内镜切除治疗的20例21个病变中,12个浸润至黏膜下层(20~520µm),9个为黏膜内癌。无淋巴管及血管浸润,水平及垂直切缘阴性。免疫组化染色结果:胃蛋白酶原Ⅰ和MUC6阳性,H+-K+-ATPase散在少数阳性,Ki-67肿瘤细胞增殖指数低,MUC5AC、MUC2和CD10均阴性。患者平均随访15.85个月,期间均无复发或转移。结论GA-FG-CCP是一种分化非常好的罕见肿瘤类型,临床症状不明显,但内镜下有特征性表现,应用白光和窄带光成像放大观察可提高检出率,病理和免疫组化染色可明确诊断。
