Gastric epithelial neoplasm of fundic-gland mucosa lineage: proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type.
Gastric adenocarcinoma of fundic-gland mucosa type
Gastric adenocarcinoma of fundic-gland type
Gastric epithelial neoplasm of fundic-gland mucosa lineage
Oxyntic gland adenoma
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
24
04
2021
accepted:
10
07
2021
pubmed:
17
7
2021
medline:
15
12
2021
entrez:
16
7
2021
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34268625
doi: 10.1007/s00535-021-01813-z
pii: 10.1007/s00535-021-01813-z
pmc: PMC8370942
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
814-828Informations de copyright
© 2021. The Author(s).
Références
Pathol Int. 2017 Mar;67(3):147-155
pubmed: 28105693
Hum Pathol. 2013 Nov;44(11):2438-48
pubmed: 24011952
World J Gastroenterol. 2006 Apr 28;12(16):2510-6
pubmed: 16688795
Pathol Int. 2007 Aug;57(8):517-22
pubmed: 17610477
Mod Pathol. 2020 Feb;33(2):206-216
pubmed: 31375767
Medicine (Baltimore). 2018 Sep;97(37):e12341
pubmed: 30212986
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
Endoscopy. 2015;47 Suppl 1 UCTN:E177-8
pubmed: 25928827
Dig Endosc. 2011 Jul;23(3):244-6
pubmed: 21699569
Endoscopy. 2014 Feb;46(2):153-7
pubmed: 24338239
World J Gastroenterol. 2015 Apr 28;21(16):5099-104
pubmed: 25945027
Medicine (Baltimore). 2017 Jun;96(23):e7080
pubmed: 28591047
Clin J Gastroenterol. 2016 Dec;9(6):345-351
pubmed: 27624750
Gastric Cancer. 2021 Jan;24(1):1-21
pubmed: 32060757
Intern Med. 2013;52(14):1585-8
pubmed: 23857090
Am J Surg Pathol. 2012 Jul;36(7):1030-5
pubmed: 22472957
Clin Gastroenterol Hepatol. 2015 Nov;13(11):A17-8
pubmed: 26215839
Hum Pathol. 2014 Dec;45(12):2488-96
pubmed: 25288233
Am J Surg Pathol. 2010 May;34(5):609-19
pubmed: 20410811
Virchows Arch. 2015 Jul;467(1):27-38
pubmed: 25820416
Korean J Pathol. 2012 Jun;46(3):287-91
pubmed: 23110017
Pathol Int. 2013 Jun;63(6):318-25
pubmed: 23782334
Digestion. 2017;96(2):81-91
pubmed: 28738329
Clin J Gastroenterol. 2017 Jun;10(3):224-228
pubmed: 28258560
Histopathology. 2016 May;68(6):825-33
pubmed: 26335020
Int J Clin Exp Pathol. 2011;4(8):797-8
pubmed: 22135729
J Pathol. 2013 Mar;229(4):579-87
pubmed: 23208952
World J Gastroenterol. 2018 Jul 14;24(26):2915-2920
pubmed: 30018486
Dig Endosc. 2014 Mar;26(2):293-4
pubmed: 24321002
Am J Clin Pathol. 2018 Apr 25;149(6):461-473
pubmed: 29648578
J Gastric Cancer. 2018 Dec;18(4):409-416
pubmed: 30607304
J Gastrointest Cancer. 2012 Sep;43 Suppl 1:S262-5
pubmed: 22791069
World J Gastroenterol. 2015 Jul 14;21(26):8208-14
pubmed: 26185396