Gastric epithelial neoplasm of fundic-gland mucosa lineage: proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type

被引：54

作者：

Ueyama, Hiroya ^{[1
]}

Yao, Takashi ^{[2
]}

Akazawa, Yoichi ^{[1
]}

Hayashi, Takuo ^{[3
]}

Kurahara, Koichi ^{[4
]}

Oshiro, Yumi ^{[5
]}

Yamada, Masaoshi ^{[6
]}

Oda, Ichiro ^{[6
]}

Fujioka, Shin ^{[7
]}

Kusumoto, Chiaki ^{[8
]}

Fukuda, Masayoshi ^{[9
]}

Uchita, Kunihisa ^{[10
]}

Kadota, Tomohiro ^{[11
]}

Oono, Yasuhiro ^{[11
]}

Okamoto, Kazuhisa ^{[12
]}

Murakami, Kazunri ^{[12
]}

Matsuo, Yasumasa ^{[13
]}

Kato, Motohiko ^{[14
,15
]}

Maehata, Tadateru ^{[15
]}

Yahagi, Naohisa ^{[15
]}

Yasuhara, Yumiko ^{[16
]}

Yada, Tomoyuki ^{[17
]}

Uraushihara, Koji ^{[18
]}

Yamane, Tetumi ^{[19
]}

Matsuo, Taiji ^{[20
]}

Ito, Masanori ^{[21
]}

Maruyama, Yasuhiko ^{[22
]}

Osako, Ayumi ^{[23
]}

Ono, Shoko ^{[24
]}

Kato, Mototsugu ^{[25
]}

Yagi, Kazuyoshi ^{[26
]}

Hashimoto, Takashi ^{[27
]}

Tomita, Natsumi ^{[27
]}

Tsuyama, Sho ^{[3
]}

Saito, Tsuyoshi ^{[3
]}

Matsumoto, Kohii ^{[1
]}

Matsumoto, Kenshi ^{[1
]}

Watanabe, Sumio ^{[1
]}

Uemura, Naomi ^{[17
]}

Chiba, Tsutomu ^{[28
,29
]}

Nagahara, Akihiito ^{[1
]}

机构：

[1] Juntendo Univ, Dept Gastroenterol, Sch Med, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan

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

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

[4] Matsuyama Red Cross Hosp, Dept Gastroenterol, Matsuyama, Ehime, Japan

[5] Matsuyama Red Cross Hosp, Dept Pathol, Matsuyama, Ehime, Japan

[6] Natl Canc Ctr, Endoscopy Div, Tokyo, Japan

[7] Fukuoka Red Cross Hosp, Div Gastroenterol, Fukuoka, Japan

[8] Nippon Kokan Fukuyama Hosp, Dept Gastroenterol, Hiroshima, Japan

[9] Tokyo Med & Dent Univ, Dept Gastroenterol & Hepatol, Tokyo, Japan

[10] Kochi Red Cross Hosp, Dept Gastroenterol, Kochi, Japan

[11] Natl Canc Ctr Hosp East, Dept Gastroenterol & Endoscopy, Chiba, Japan

[12] Oita Univ, Fac Med, Dept Gastroenterol, Oita, Japan

[13] St Marianna Univ, Div Gastroenterol & Hepatol, Dept Internal Med, Sch Med, Kawasaki, Kanagawa, Japan

[14] Keio Univ, Dept Internal Med, Div Gastroenterol & Hepatol, Sch Med, Tokyo, Japan

[15] Keio Univ, Canc Ctr, Div Res & Dev Minimally Invas Treatment, Sch Med, Tokyo, Japan

[16] Kyoto Katsura Hosp, Dept Diagnost Pathol, Kyoto, Japan

[17] Kohnodai Hosp, Natl Ctr Global Hlth & Med, Dept Gastroenterol & Hepatol, Chiba, Japan

[18] Showa Gen Hosp, Dept Gastroenterol & Hepatol, Tokyo, Japan

[19] Tottori Red Cross Hosp, Dept Diagnost Pathol, Tottori, Japan

[20] Hiroshima Univ Hosp, Dept Endoscopy, Hiroshima, Japan

[21] Hiroshima Univ Hosp, Dept Gen Internal Med, Hiroshima, Japan

[22] Fujieda Municipal Gen Hosp, Dept Gastroenterol, Shizuoka, Japan

[23] Tottori Seikyo Hosp, Dept Gastroenterol, Tottori, Japan

[24] Hokkaido Univ Hosp, Dept Gastroenterol, Sapporo, Hokkaido, Japan

[25] Hakodate Natl Hosp, Dept Gastroenterol, Natl Hosp Org, Hakodate, Hokkaido, Japan

[26] Niigata Univ Med & Dent Hosp, Uonuma Inst Community Med, Dept Gastroenterol & Hepatol, Niigata, Japan

[27] Juntendo Univ, Dept Esophageal & Gastroenterol Surg, Sch Med, Tokyo, Japan

[28] Kyoto Univ, Dept Gastroenterol & Hepatol, Grad Sch Med, Kyoto, Japan

[29] Kansai Elect Power Hosp, Osaka, Japan

来源：

JOURNAL OF GASTROENTEROLOGY | 2021年 / 56卷 / 09期

关键词：

Gastric adenocarcinoma of fundic-gland type; Gastric adenocarcinoma of fundic-gland mucosa type; Gastric epithelial neoplasm of fundic-gland mucosa lineage; Oxyntic gland adenoma; CATENIN SIGNALING PATHWAY; WELL-DIFFERENTIATED ADENOCARCINOMA; STOMACH; MUTATION; ADENOMA; GNAS;

D O I：

10.1007/s00535-021-01813-z

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Gastric adenocarcinoma of fundic-gland type (GA-FG) is a rare variant of gastric neoplasia. However, the etiology, classification, and clinicopathological features of gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML; generic term of GA-FG related neoplasm) are not fully elucidated. We performed a large, multicenter, retrospective study to establish a new classification and clarify the clinicopathological features of GEN-FGML. Methods One hundred GEN-FGML lesions in 94 patients were collected from 35 institutions between 2008 and 2019. We designed a new histopathological classification of GEN-FGML using immunohistochemical analysis and analyzed via clinicopathological, immunohistochemical, and genetic evaluation. Results GEN-FGML was classified into 3 major types; oxyntic gland adenoma (OGA), GA-FG, and gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM). In addition, GA-FGM was classified into 3 subtypes; Type 1 (organized with exposure type), Type 2 (disorganized with exposure type), and Type 3 (disorganized with non-exposure type). OGA and GA-FG demonstrated low-grade epithelial neoplasm, and GA-FGM should be categorized as an aggressive variant of GEN-FGML that demonstrated high-grade epithelial neoplasm (Type 2 > 1, 3). The frequent presence of GNAS mutation was a characteristic genetic feature of GEN-FGML (7/34, 20.6%; OGA 1/3, 33.3%; GA-FG 3/24, 12.5%; GA-FGM 3/7, 42.9%) in mutation analysis using next-generation sequencing. Conclusions We have established a new histopathological classification of GEN-FGML and propose a new lineage of gastric epithelial neoplasm that harbors recurrent GNAS mutation. This classification will be useful to estimate the malignant potential of GEN-FGML and establish an appropriate standard therapeutic approach.

引用

页码：814 / 828

页数：15

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