Fundic gland type neoplasms: endoscopic and clinicopathological analysis of 17 cases

doi:10.3877/cma.j.issn.2095-7157.2025.02.008

Abstract

Abstract:

Objective

This study aims to investigate the endoscopic, clinicopathological features,treatment and prognosis of fundic gland type neoplasms.

Methods

A retrospective analysis was conducted on 17 patients diagnosed with fundic gland type neoplasms from January 2021 to August 2024 at the Department of Pathology, First Medical Center of the PLA General Hospital. The clinical information,endoscopic findings, pathological data were collected and analyzed in conjunction with relevant literature.

Results

Among these cases, there were 12 cases of oxyntic gland adenoma (OGA), 3 cases of gastric adenocarcinoma of the fundic gland type (GA-FG), and 2 cases of gastiric adenocarcinoma of fundic gland mucosa type (GA-FGM). There were 12 males and 5 females with a median age of 58 years. The endoscopic tumors were classified as type 0-I (6 cases),type 0-Ⅱa (7 cases),type 0-Ⅱb (2 cases),and type 0-Ⅱa+Ⅱc (2 cases). Histologically, the tumor exhibited differentiation towards gastric fundus glands with evident structural atypia including dense glands with irregular shapes and partial fusion. Small cell atypia was observed predominantly along with main cell differentiation. Immunohistochemical staining showed that fundic gland type neoplasms expressed pepsinogen 1, MUC6. OGA and GA-FG were negative for MUC5AC, Ki-67 proliferation index was low, GA-FGM expressed MUC5AC in different degrees, Ki-67 proliferation index was high.

Conclusion

Fundic gland type neoplasms are rare neoplasms originating from the same lineage that exhibit variable degrees of invasiveness but generally have an indolent course. They possess distinct endoscopic manifestations and clinicopathological features requiring due attention in the routine pathological diagnosis.

Key words: Fundic gland type neoplasms, Oxyntic gland adenoma, Gastric adenocarcinoma of the fundic gland type, Gastiric adenocarcinoma of fundic gland mucosa type, Endoscopic features, Endoscopic resection

Linru Wang, Nan Zhang, Song Su, Shuying Li, Wei Chen, Xuebin Cheng, Jing Yuan. Fundic gland type neoplasms: endoscopic and clinicopathological analysis of 17 cases[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2025, 12(02): 107-113.

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Figures/Tables 4

References 21

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序号	性别	年龄	临床表现	部位	内镜形态巴黎分型	直径（cm）	诊断	HP	萎缩	肠化	治疗
1	男	53	无特殊	胃底	0-Ⅱb	0.6	OGA	-	-	-	ESD
2	男	59	食欲欠佳,消瘦1月	胃底	0-Ⅱa	0.5	OGA	-	-	-	活检
3	女	62	无特殊	胃底	0-Ⅰs	0.3	OGA	-	-	-	活检
4	女	68	间断胸骨后不适3月	胃底	0-Ⅱa	1.5	OGA	-	-	-	ESD
5	男	60	无特殊	胃底	0-Ⅰs	0.2	OGA	-	-	+	活检
6	男	52	间断腹痛,餐后加重两年	胃底	0-Ⅱa	0.8	OGA	-	-	+	ESD
7	男	68	无特殊	胃体	0-Ⅱb	0.6	OGA	-	-	-	EMR
8	女	78	无特殊	胃体	0-Ⅰs	0.3	OGA	-	-	-	活检
9	女	58	烧心、嗳气6月	胃体	0-Ⅱa	0.6	OGA	-	-	-	根治性近端胃大部切除术
10	女	83	便血5日	胃体	0-Ⅰs	0.5	OGA	-	-	-	活检
11	男	49	无特殊	胃体	0-Ⅰsp	0.5	OGA	-	-	-	活检+胰十二指肠切除术
12	男	32	无特殊	胃底	0-Ⅰsp	0.8	OGA	-	-	-	活检
13	男	49	间断进食后胃部隐痛2年	胃底	0-Ⅱa+Ⅱc	0.4	GA-FG	-	-	-	ESD
14	男	55	间断进食困难半月	胃窦	0-Ⅱa+Ⅱc	1	GA-FG	+	-	+	ESD
15	男	70	无特殊	胃底	0-Ⅱa	0.6	GA-FG	-	-	-	ESD
16	男	40	腹部不适1月	胃体	0-Ⅱa	1	GA-FGM	-	+	-	ESD
17	男	51	进食后上腹部胀痛2月	胃体	0-Ⅱa	3	GA-FGM	-	-	-	根治性全胃切除术

序号	性别	年龄	临床表现	部位	内镜形态巴黎分型	直径（cm）	诊断	HP	萎缩	肠化	治疗
1	男	53	无特殊	胃底	0-Ⅱb	0.6	OGA	-	-	-	ESD
2	男	59	食欲欠佳,消瘦1月	胃底	0-Ⅱa	0.5	OGA	-	-	-	活检
3	女	62	无特殊	胃底	0-Ⅰs	0.3	OGA	-	-	-	活检
4	女	68	间断胸骨后不适3月	胃底	0-Ⅱa	1.5	OGA	-	-	-	ESD
5	男	60	无特殊	胃底	0-Ⅰs	0.2	OGA	-	-	+	活检
6	男	52	间断腹痛,餐后加重两年	胃底	0-Ⅱa	0.8	OGA	-	-	+	ESD
7	男	68	无特殊	胃体	0-Ⅱb	0.6	OGA	-	-	-	EMR
8	女	78	无特殊	胃体	0-Ⅰs	0.3	OGA	-	-	-	活检
9	女	58	烧心、嗳气6月	胃体	0-Ⅱa	0.6	OGA	-	-	-	根治性近端胃大部切除术
10	女	83	便血5日	胃体	0-Ⅰs	0.5	OGA	-	-	-	活检
11	男	49	无特殊	胃体	0-Ⅰsp	0.5	OGA	-	-	-	活检+胰十二指肠切除术
12	男	32	无特殊	胃底	0-Ⅰsp	0.8	OGA	-	-	-	活检
13	男	49	间断进食后胃部隐痛2年	胃底	0-Ⅱa+Ⅱc	0.4	GA-FG	-	-	-	ESD
14	男	55	间断进食困难半月	胃窦	0-Ⅱa+Ⅱc	1	GA-FG	+	-	+	ESD
15	男	70	无特殊	胃底	0-Ⅱa	0.6	GA-FG	-	-	-	ESD
16	男	40	腹部不适1月	胃体	0-Ⅱa	1	GA-FGM	-	+	-	ESD
17	男	51	进食后上腹部胀痛2月	胃体	0-Ⅱa	3	GA-FGM	-	-	-	根治性全胃切除术

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