Background and study aims

Gastric adenocarcinoma of fundic-gland type (GA-FG) was first proposed as a new entity of gastric adenocarcinoma in 2010. Subsequently, gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM) was reported as a subtype of gastric adenocarcinoma. This study aimed to investigate the endoscopic findings of GA-FGM and to evaluate the differences between GA-FGM and GA-FG.

Patients and methods

This was a single-center retrospective study. Participants were selected from patients with gastric cancer treated at Fukuoka University Chikushi Hospital, between September 2007 and May 2020. Patients histologically diagnosed with GA-FGM or GA-FG were enrolled, and endoscopic findings were analyzed in detail.

Results

A total of 12 GA-FGM lesions (12 patients) and 14 GA-FG lesions (13 patients) were analyzed. The two lesion types showed similar features: most lesions were of elevated type, located in the upper stomach, and developed in the stomach without Helicobacter pylori infection. On conventional endoscopy using the dye-spraying method, well-demarcated fine granular areas were observed in 7 GA-FGM lesions (58%) but not in any GA-FG lesions, with a significant difference between the two groups (P = 0.001). Magnifying endoscopy with narrow-band imaging (NBI) showed that 11 GA-FGM lesions (92%) met the diagnostic criteria for cancer according to the vessel plus surface classification system, whereas none of the GA-FG lesions met the same criteria (0%, 0/14) (P = 0.001).

Conclusion

Our results suggest that magnifying endoscopy with NBI is a potentially useful method for the diagnosis of GA-FGM.

中文翻译：

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胃底-腺黏膜型胃腺癌的特征性内镜表现

背景和研究目的

胃底腺型胃腺癌（GA-FG）于2010年首次被提出作为胃腺癌的一个新实体。随后，胃底腺黏膜型胃腺癌（GA-FGM）被报道为胃腺癌的一个亚型。本研究旨在调查 GA-FGM 的内窥镜检查结果，并评估 GA-FGM 和 GA-FG 之间的差异。

患者和方法

这是一项单中心回顾性研究。参与者选自 2007 年 9 月至 2020 年 5 月在福冈大学筑紫医院接受治疗的胃癌患者。招募组织学诊断为 GA-FGM 或 GA-FG 的患者，并详细分析内镜检查结果。

结果

共分析了 12 个 GA-FGM 病灶（12 名患者）和 14 个 GA-FG 病灶（13 名患者）。两种病变类型表现出相似的特征：大多数病变为隆起型，位于胃上部，在没有幽门螺杆菌感染的胃中发展。常规喷染法内镜下，7个GA-FGM病灶（58%）出现界限清楚的细颗粒区，而GA-FG病灶均未见，两组比较差异有统计学意义（P  =0.001） . 放大内镜窄带成像（NBI）显示，根据血管加表面分类系统，11个GA-FGM病灶（92%）符合癌症诊断标准，而没有一个GA-FG病灶符合相同标准（0 %, 0/14) ( P  = 0.001)。

结论

我们的结果表明，放大内窥镜检查与 NBI 是诊断 GA-FGM 的潜在有用方法。