胃泌酸腺腺瘤和胃底腺型腺癌临床病理分析

Clinicopathological features of oxyntic gland adenoma and gastric adenocarcinoma of fundic gland type

目的 探讨泌酸腺腺瘤(OGA)及胃底腺型腺癌(GA-FG)临床病理特征、诊断及鉴别诊断。方法 收集2019-07—2021-12成都市第三人民医院收治的9例OGA/GA-FG,分析内镜、组织形态学及免疫表型特征。结果 9例患者女性6人,男性3人,平均年龄65岁。病变主要位于胃底,平均直径9.6 mm(最大直径16 mm)。3例为OGA,1例浸润至黏膜肌层,2例位于黏膜内。6例为GA-FG,均浸润至黏膜下层(平均160μm),其中1例周边黏膜出现中-低分化腺癌。结论 OGA定义为良性上皮性肿瘤,GA-FG是一种新型的分化良好的轻度异型性腺癌,具有独特的病理学特征,罕见伴发中-低分化腺癌情况。故充分了解其组织学形态及生物学行为,可提高临床医师对其诊断能力。

Objective To investigate the clinicopathological characteristics of oxyntic gland adenoma(OGA) and gastric adenocarcinoma of the fundic gland(GA-FG). Methods Samples were collected from 9 patients diagnosed with OGA/GA-FG admitted from July 2019 to December 2021 at the Chendu Third People’s Hospital. Endoscopic features, pathological appearance, and immunohistochemical staining were assessed. Results There were 3 male and 6 female patients, and the mean age was 65 years. The lesions were mainly located in the fundus, with an average diameter of 9.6 mm(maximum diameter 16 mm). In 3 cases of OGA, there was 1 tumor invading into the mucosal muscle layer, and 2 cases were located in the mucosa. 6 cases of GA-FG invaded into the submucosal layer(average 16 mm), and one case was moderately-poorly differentiated adenocarcinoma in the peripheral mucosa. Conclusion OGA is a benign epithelial neoplasm. GA-FG is a a new type and well-differentiated adenocarcinoma which has unique pathological characteristics. But it can also be rare with moderately to poorly differentiated adenocarcinoma. Therefore, a full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinicians.