ABSTRACT
Objective:
To analyze and summarize the clinical characteristics, endoscopic manifestations,
pathology and
treatment of gastric
adenocarcinoma of the fundic gland(GA-FD)to promote clinicians'
understanding of this
disease.
Methods:
The clinical data of 3
patients with GA-FD admitted to
Beijing Hospital from May 2020 to January 2022 were retrospectively analyzed.Among them, 2 presented with abdominal distension or
abdominal pain.The other case was diagnosed during follow-up
endoscopy after
gastrectomy for
gastric cancer.A
diagnosis of GA-FD was made based on the results of
white light imaging, magnifying
endoscopy,
pathology and
immunohistochemistry.In addition, we reviewed the
literature about GA-FD between January 1990 and April 2021 from both national and international
reports of 195 cases.We analyzed and summarized the endoscopic and pathological characteristics of the
disease and insights on its
diagnosis and
treatment.
Results:
Of all 198 cases,
patients had a
male/
female ratio of 1.6/1.0 and an average age of 65.3 years(range 39-87 years).79.82%(91/114)of the
patients were negative for
Helicobacter pylori.
Gastroscopy showed that the average diameter was 8.97 mm, and 89.9%(178/198)of the
patients had lesions infiltrating into the submucosa.91.98%(149/162)of the
patients had
gastric chief cells as the predominant
cell type, 98.86%(130/140)had no lymphovascular invasion, and 97.6%(162/166)had no
recurrence or
metastasis.
Conclusions:
GA-FD is a rare
gastric cancer, with low-grade atypia and highly differentiated
tissues.The mechanisms of GA-FD are not clear and the
disease is more commonly seen in the
elderly.There is no obvious correlation between
Helicobacter pylori infections and GA-FD.
Gastric chief cells make up the predominant
cell type.The results of
endoscopy,
pathology and
immunohistochemistry can help confirm the
diagnosis.The
prognosis of most cases is good.