Clinicopathological and molecular characterization of early gastric adenocarcinoma in Helicobacter pylori-uninfected patients: emphasis on differentiated gastric adenocarcinoma

被引：9

作者：

Akazawa, Yoichi ^{[1
]}

Ueyama, Hiroya ^{[1
]}

Hayashi, Takuo ^{[2
]}

Utsunomiya, Hisanori ^{[1
]}

Uchida, Ryota ^{[1
]}

Abe, Daiki ^{[1
]}

Oki, Shotaro ^{[1
]}

Suzuki, Nobuyuki ^{[1
]}

Ikeda, Atsushi ^{[1
]}

Yatagai, Noboru ^{[1
]}

Komori, Hiroyuki ^{[1
]}

Takeda, Tsutomu ^{[1
]}

Matsumoto, Kohei ^{[1
]}

Ueda, Kumiko ^{[1
]}

Matsumoto, Kenshi ^{[1
]}

Asaoka, Daisuke ^{[1
]}

Hojo, Mariko ^{[1
]}

Saito, Tsuyoshi ^{[2
]}

Yao, Takashi ^{[3
]}

Nagahara, Akihito ^{[1
]}

机构：

[1] Juntendo Univ, Dept Gastroenterol, Sch Med, Tokyo, Japan

[2] Juntendo Univ, Dept Human Pathol, Sch Med, Bunkyo Ku, 1-1-19 Hongo, Tokyo, Japan

[3] Juntendo Univ, Dept Human Pathol, Grad Sch Med, Tokyo, Japan

来源：

JOURNAL OF GASTROENTEROLOGY | 2022年 / 57卷 / 10期

关键词：

Gastric cancer; Helicobacter pylori; Helicobacter pylori-uninfected gastric cancer; Next-generation sequencing; FUNDIC GLAND TYPE; CANCER; INFECTION; NEOPLASIA; STOMACH;

D O I：

10.1007/s00535-022-01906-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Recently, Helicobacter pylori (HP)-uninfected gastric mucosal cancer has been reported; however, the clinicopathological and molecular features of HP-uninfected gastric cancer have not been elucidated. Methods We evaluated the clinicopathological, immunohistochemical, and genetic alterations in HP-uninfected early gastric adenocarcinoma using next-generation sequencing (NGS). Results Among 968 primary early gastric carcinomas, 64 (6.6%) were HP-uninfected gastric adenocarcinoma and were pathologically classified as gastric adenocarcinoma of fundic-gland type (GA-FG, n = 39), differentiated gastric adenocarcinoma (DGA, n = 16), and signet-ring cell carcinoma (SRCC, n = 9). Based on the expression profile of the mucin core protein, DGAs were classified into a gastrointestinal phenotype showing either MUC5AC or MUC6 expression and MUC2 or CD10 expression simultaneously (n = 5), and a gastric phenotype (n = 11) showing either MUC5AC or MUC6 expression. All DGAs with a gastrointestinal phenotype shared similar endoscopic characteristics, such as reddish depressed lesions in the antrum. In contrast, DGAs with a gastric phenotype exhibited several distinct endoscopic features, including a raspberry-shaped appearance and whitish flat-elevated appearance; the former expressed only MUC5AC and the latter exhibited co-expression of MUC5AC and MUC6. Among 16 HP-uninfected DGAs, seven were subjected to NGS. APC was recurrently mutated in DGA (42.9%) and was enriched in DGAs with a gastrointestinal phenotype (75%). Conclusions Overall, HP-uninfected gastric adenocarcinomas showed distinct clinicopathologic and endoscopic characteristics. Furthermore, HP-uninfected DGAs, especially those with a gastrointestinal phenotype, may be characterized by recurrent APC mutations.

引用

页码：725 / 734

页数：10

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