BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing li...BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.展开更多
BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric ...BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.展开更多
Introduction Gastric adenocarcinoma of the fundic gland type(GA-FG)is an epithelial tumor characterized by low-grade atypia and differentiation toward fundic glands.GA-FG lesions have been reported to be covered by no...Introduction Gastric adenocarcinoma of the fundic gland type(GA-FG)is an epithelial tumor characterized by low-grade atypia and differentiation toward fundic glands.GA-FG lesions have been reported to be covered by normal foveolar epithelium and arise from the non-atrophic mucosa of the upper or middle stomach[1].At the same time,these lesions originate from the deep layers of the gastric mucosa and can be macroscopically observed with diverse various endoscopic features,such as a submucosal tumor(SMT)-like morphology.Here,we present a rare case involving nine GA-FG lesions with varying endoscopic features in autoimmune gastritis(AIG).展开更多
文摘BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.
文摘BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.
基金supported by the crosswise tasks from Taide Pharmaceutical Co.,Ltd,China[2021KT1155]。
文摘Introduction Gastric adenocarcinoma of the fundic gland type(GA-FG)is an epithelial tumor characterized by low-grade atypia and differentiation toward fundic glands.GA-FG lesions have been reported to be covered by normal foveolar epithelium and arise from the non-atrophic mucosa of the upper or middle stomach[1].At the same time,these lesions originate from the deep layers of the gastric mucosa and can be macroscopically observed with diverse various endoscopic features,such as a submucosal tumor(SMT)-like morphology.Here,we present a rare case involving nine GA-FG lesions with varying endoscopic features in autoimmune gastritis(AIG).
