HISTOPATHOLOGICAL CLASSIFICATION AND ENDOSCOPIC MEDICAL PRACTICE OF GASTRIC EPITHELIAL NEOPLASM OF FUNDIC-GLAND MUCOSA LINEAGE

Abstract

Gastric adenocarcinoma of the fundic gland type is a gastric epithelial neoplasia newly added to the 15th edition of the Japanese Gastric Cancer Guideline and the 5th edition of the WHO Classification of Tumors. We proposed gastric adenocarcinoma of the fundic gland type as a rare gastric epithelial neoplasia with low-grade atypia in 2010. Gastric epithelial neoplasm of fundic-gland mucosa lineage is considered a Helicobacter pylori-uninfected gastric cancer and can be histopathologically classified as gastric adenocarcinoma of the fundic gland type and gastric adenocarcinoma of the fundic gland mucosa type. Clinicopathological and endoscopic features have also been elucidated. Although there have been several reports on genetic abnormalities, the risk factors and mechanisms of carcinogenesis have not been clarified. In addition, gastric adenocarcinoma of the fundic gland type demonstrates low-grade epithelial neoplasm, and its clinical treatment strategy, including the indication for additional surgery after endoscopic treatment, is controversial. In the future, treatment outcomes and long-term prognostic analysis based on histopathological classification should be performed to establish guidelines for the endoscopic treatment of gastric epithelial neoplasms of fundic-gland mucosa lineage.