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Abstract
The aim of this study was to reveal the histological features of oxyntic gland adenomas and gastric adenocarcinoma of the fundic-gland type (GA-FG). We retrospectively examined the histological features of 126 lesions of oxyntic gland adenoma and/or GA-FG in 116 patients. The prevalence of oxyntic gland adenomas and GA-FG was approximately equal. The majority of the lesions were resected by endoscopic mucosal resection using a diathermic snare (EMR, n = 42) or endoscopic submucosal dissection (ESD, n = 72). Histologically, there were no lesions with invasion at the level of the muscularis propria or deeper, and lymphovascular invasion was present in 1.6%. Of the ESD and EMR specimens, there were no lesions that were positive for vertical margins. Among the eight GA-FG patients with deep (≥ 500 μm) submucosal invasion, six were treated with endoscopic resection alone, and no recurrence was documented. No patients died of the disease during the median follow-up period of 14.5 months. In conclusion, all lesions were confined to the mucosa or submucosa and were negative for vertical margins. Lymphovascular invasion was present in only 1.6% of the patients. Thus, we believe that endoscopic resection is a suitable initial treatment method for oxyntic gland adenoma and GA-FG.
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1 Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Gastroenterology and Hepatology, Okayama, Japan (GRID:grid.261356.5) (ISNI:0000 0001 1302 4472)
2 Nippon Kokan Fukuyama Hospital, Department of Gastroenterology, Fukuyama, Japan (GRID:grid.261356.5)
3 Hiroshima City Hospital, Department of Internal Medicine, Hiroshima, Japan (GRID:grid.414157.2) (ISNI:0000 0004 0377 7325)
4 Fukuyama City Hospital, Department of Internal Medicine, Fukuyama, Japan (GRID:grid.415161.6) (ISNI:0000 0004 0378 1236)
5 Okayama Saiseikai General Hospital, Department of Internal Medicine, Okayama, Japan (GRID:grid.416814.e) (ISNI:0000 0004 1772 5040)
6 Kagawa Prefectural Central Hospital, Department of Gastroenterology, Takamatsu, Japan (GRID:grid.414811.9) (ISNI:0000 0004 1763 8123)
7 Fukuyama Medical Center, Department of Gastroenterology, Fukuyama, Japan (GRID:grid.414811.9)
8 National Hospital Organization Shikoku Cancer Center, Department of Endoscopy, Matsuyama, Japan (GRID:grid.415740.3) (ISNI:0000 0004 0618 8403)
9 Iwakuni Clinical Center, Department of Gastroenterology, Iwakuni, Japan (GRID:grid.415740.3)
10 Kurashiki Central Hospital, Department of Gastroenterology and Hepatology, Kurashiki, Japan (GRID:grid.415565.6) (ISNI:0000 0001 0688 6269)
11 Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Pathology, Okayama, Japan (GRID:grid.261356.5) (ISNI:0000 0001 1302 4472)