A clinicopathological study of nine cases of gastric adenocarcinoma of the fundic gland type, diagnosed by screening gastroscopy

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  • 胃内視鏡検診で発見された胃底腺型胃癌の臨床病理学的検討
  • 経験 胃内視鏡検診で発見された胃底腺型胃癌の臨床病理学的検討
  • ケイケン イ ナイシキョウ ケンシン デ ハッケン サレタ イテイセンガタ イガン ノ リンショウ ビョウリガクテキ ケントウ

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<p>We studied the clinicopathological features of eight cases of gastric adenocarcinoma of the fundic gland type and one case of gastric adenocarcinoma of the fundic mucosa type, which were diagnosed in our hospital. These nine cases comprised 4.0% of all stomach cancers occurring in the same period. ESD was performed for eight cases, and one case was not treated. The mean patient age was 58.0 years. Five of the nine cases were male. Seven cases were negative and two were positive for Helicobacter pylori infection. Seven lesions occurred in the upper region of the stomach and two in the middle. Five macroscopic types were represented: one type 0-I, five 0-IIa, one 0-IIb, one 0-IIc, and one 0-IIa+IIc. The surface color of the tumor was normal in one lesion and whitish in eight lesions. Six lesions had dilated surface vessels with branching architecture. The mean tumor size was 4.8 mm. Eight lesions were grouped into three “depths of invasion”: three T1a (M), four T1b1 (SM1), and one T1b2 (SM2). All lesions were negative for vascular invasion. Annual screening was performed in two cases. One case, which was low-grade gastric adenocarcinoma of the fundic gland type, grew slowly for 7 years, whereas the other case, which was high-grade gastric adenocarcinoma of the fundic mucosa type, doubled in size in 2 years. It is anticipated that gastric adenocarcinoma of the fundic gland type will increase with a decreasing Helicobacter pylori infection rate. Therefore, endoscopists must have a thorough knowledge of the clinicopathological features of gastric adenocarcinoma of the fundic gland type.</p>

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