Gastric epithelial neoplasm of fundic-gland mucosa lineage: proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type

BACKGROUND: Gastric adenocarcinoma of fundic-gland type (GA-FG) is a rare variant of gastric neoplasia. However, the etiology, classification, and clinicopathological features of gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML; generic term of GA-FG related neoplasm) are not ful...

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Detalles Bibliográficos
Autores principales: Ueyama, Hiroya, Yao, Takashi, Akazawa, Yoichi, Hayashi, Takuo, Kurahara, Koichi, Oshiro, Yumi, Yamada, Masayoshi, Oda, Ichiro, Fujioka, Shin, Kusumoto, Chiaki, Fukuda, Masayoshi, Uchita, Kunihisa, Kadota, Tomohiro, Oono, Yasuhiro, Okamoto, Kazuhisa, Murakami, Kazunari, Matsuo, Yasumasa, Kato, Motohiko, Maehata, Tadateru, Yahagi, Naohisa, Yasuhara, Yumiko, Yada, Tomoyuki, Uraushihara, Koji, Yamane, Tetsumi, Matsuo, Taiji, Ito, Masanori, Maruyama, Yasuhiko, Osako, Ayumi, Ono, Shoko, Kato, Mototsugu, Yagi, Kazuyoshi, Hashimoto, Takashi, Tomita, Natsumi, Tsuyama, Sho, Saito, Tsuyoshi, Matsumoto, Kohei, Matsumoto, Kenshi, Watanabe, Sumio, Uemura, Naomi, Chiba, Tsutomu, Nagahara, Akihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2021
Materias:
Original Article—Alimentary Tract
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370942/
https://www.ncbi.nlm.nih.gov/pubmed/34268625
http://dx.doi.org/10.1007/s00535-021-01813-z
Descripción
Sumario:BACKGROUND: Gastric adenocarcinoma of fundic-gland type (GA-FG) is a rare variant of gastric neoplasia. However, the etiology, classification, and clinicopathological features of gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML; generic term of GA-FG related neoplasm) are not fully elucidated. We performed a large, multicenter, retrospective study to establish a new classification and clarify the clinicopathological features of GEN-FGML. METHODS: One hundred GEN-FGML lesions in 94 patients were collected from 35 institutions between 2008 and 2019. We designed a new histopathological classification of GEN-FGML using immunohistochemical analysis and analyzed via clinicopathological, immunohistochemical, and genetic evaluation. RESULTS: GEN-FGML was classified into 3 major types; oxyntic gland adenoma (OGA), GA-FG, and gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM). In addition, GA-FGM was classified into 3 subtypes; Type 1 (organized with exposure type), Type 2 (disorganized with exposure type), and Type 3 (disorganized with non-exposure type). OGA and GA-FG demonstrated low-grade epithelial neoplasm, and GA-FGM should be categorized as an aggressive variant of GEN-FGML that demonstrated high-grade epithelial neoplasm (Type 2 > 1, 3). The frequent presence of GNAS mutation was a characteristic genetic feature of GEN-FGML (7/34, 20.6%; OGA 1/3, 33.3%; GA-FG 3/24, 12.5%; GA-FGM 3/7, 42.9%) in mutation analysis using next-generation sequencing. CONCLUSIONS: We have established a new histopathological classification of GEN-FGML and propose a new lineage of gastric epithelial neoplasm that harbors recurrent GNAS mutation. This classification will be useful to estimate the malignant potential of GEN-FGML and establish an appropriate standard therapeutic approach. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00535-021-01813-z.

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