Lesion size, elevated morphology, and non or closed-type atrophy are predictive factors for gastric adenocarcinoma of the fundic gland type rather than oxyntic gland adenoma

Journal of Gastrointestinal Oncology

article

Masaya Iwamuro¹  Chiaki Kusumoto²  Masahiro Nakagawa³  Kazuhiro Matsueda⁴  Sayo Kobayashi⁵  Masao Yoshioka⁶  Tomoki Inaba⁷  Tatsuya Toyokawa⁸  Chihiro Sakaguchi⁹  Shouichi Tanaka^1,10  Takehiro Tanaka^1,11  Hiroyuki Okada¹ 

[1] Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences;Department of Gastroenterology, Nippon Kokan Fukuyama Hospital;Department of Endoscopy, Hiroshima City Hospital;Department of Gastroenterology and Hepatology, Kurashiki Central Hospital;Department of Internal Medicine, Fukuyama City Hospital;Department of Internal Medicine, Okayama Saiseikai General Hospital;Department of Gastroenterology, Kagawa Prefectural Central Hospital;Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center;Department of Endoscopy, National Hospital Organization Shikoku Cancer Center;Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center;Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences

关键词: Gastric adenocarcinoma of the fundic gland type (GA-FG);    gastric neoplasms;    oxyntic gland adenoma;    submucosal invasion;   

DOI  :  10.21037/jgo-22-870

学科分类：肿瘤学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: An oxyntic gland neoplasm confined to the mucosal layer (T1a) is classified as an oxyntic gland adenoma, whereas that with submucosal invasion (T1b) is defined as gastric adenocarcinoma of the fundic gland type (GA-FG). Methods: To reveal the differences in clinical features between them, we retrospectively investigated 136 patients with 150 oxyntic gland adenoma and GA-FG lesions. Results: The univariate analysis revealed that the mean size (GA-FG vs. oxyntic gland adenoma, 7.7±5.4 vs. 5.5±3.1 mm), the prevalence of elevated morphology (79.1% vs. 51.8%), black pigmentation within the lesion (23.9% vs. 9.6%), and non or closed-type atrophy (81.2% vs. 65.1%) were different between the two groups. A multivariate logistic regression analysis revealed that ≥5 mm lesion size (odds ratio, 2.96; 95% confidence interval: 1.21–7.23), elevated morphology (odds ratio, 2.40; 95% confidence interval: 1.06–5.45), and no or closed-type atrophy (odds ratio, 2.49; 95% confidence interval: 1.07–5.80) were factors in distinguishing GA-FG from oxyntic gland adenoma. When oxyntic gland neoplasms with no or one feature were judged as oxyntic gland adenomas and those with two or three features were judged as GA-FG, the sensitivity and specificity were 85.1% and 43.4% for GA-FG, respectively. Conclusions: We identified three possible distinctive features of GA-FG compared to oxyntic gland adenoma: lesion size ≥5 mm, elevated morphology, and no or closed-type atrophy.

【 授权许可】

Unknown