胃泌酸腺腺瘤和胃底腺型腺癌临床病理特征分析

Analysis of Gastric Oxyntic Gland Adenoma and Gastric Adenocarcinoma of Fundic Gland Type Clinicopathologic Study

目的 探讨胃泌酸腺腺瘤(gastric oxyntic gland adenoma,GOGA)和胃底腺型腺癌(gastric adenocarcinoma of fundic gland type,GA-FC)的临床、病理特征、诊断及预后。方法 收集2020年1月—2021年12月4例GOGA和2例GA-FC,分析临床、病理、免疫组化特征及预后,并复习相关文献。结果 4例GOGA内镜示肿物与周边黏膜边界不清的褪色样隆起或平坦的黏膜下病变,病理表现为腺体融合呈管状、筛状,边缘规则无成角,Ki67 <2%;2例GA-FC内镜示肿物与周边黏膜边界清楚的褪色样隆起或平坦的黏膜下病变,表面可有不规则的结构,病理结构异型更明显,腺体融合呈筛状、迷路样,边缘不规则可见成角,间质轻度纤维化,Ki67> 2%。结论 泌酸腺腺瘤与胃底腺型腺癌两者属于同一生物学谱系的两端,两者在临床病理上具有共性的同时也有各自的特性。

Objective To investigate the clinicopathological features,and diagnosis and prognosis the gastric oxyntic gland adenoma(GOGA)and gastric adenocarcinoma of fundic gland type(GA-FC).Methods From January 2020 to December 2022,the clinical,pathological and immunohistochemical features and prognosis of 4 cases of GOGA and 2 cases of GA-FC were analyzed,and we reviewed some pertinent literatures.Results A total of 4 cases of GOGA endoscopy show ill-defined borders that discolored elevated or flat submucosal lesions.The pathological showed glandular fusion,tubular and cribriform,regular and unangulated margins,Ki67 2%.2cases of GA-FC endoscopy showed clear borders,that discolored elevated or flat submucosal lesions,Irregular surface structure.The pathological structural atypia was more pronounced glandular fusion,cribriform and labyrinthiform,irregular marginsa and mild interstitial fibrosis,Ki67 >2%.Conclusion The GOGA and GA-FC belong to the two ends of a biological lineage,and they have similarities in clinicopathology,but also have some differences.