Abstract
Objective: Since Ueyama, Yao et al proposed fundic gland type gastric adenocarcinoma as a new tissue subtype of gastric cancer showing differentiation toward fundic glands in 2010, many cases have been reported. We examined the clinical and pathologic features of cases of fundic gland type gastric adenocarcinoma cancer discovered in health check-ups at our center.
Subjects: The subjects were 5 persons diagnosed with fundic gland type gastric adenocarcinoma by means of upper endoscopy in health check-ups at our center from January 2012 to December 2014.
Methods: The items studied included presence/absence of Helicobacter pylori (H. pylori) infection, endoscopic findings and histopathological findings.
Results: All the subjects were male and their ages ranged from 46 to 61 years (mean age 55.6 years). All were negative for H. pylori infection but one had undergone eradication therapy. The site of origin was the U region in 4 subjects and the M region in 1 subject. The naked eye evaluation was 0-IIa in 4 subjects and 0-IIa+IIc in 1 subject. Tumor diameter did not exceed 10 mm in any subject. Treatment was by endoscopic submucosal dissection (ESD) in all 5 subjects. The evaluation of histopathological findings for all of them was fundic gland type, low-grade atypia carcinoma with infiltration into submucosa. All subjects were negative for vascular invasion and resection stumps. In immunohistochemistry, all subjects were positive for pepsinogen-I, positive for H+/K+-ATPase and positive for MUC-6 but negative for MUC-5AC and MUC-2.
Conclusion: In the future, with a decrease in H. pylori infection rates, there is a possibility of an increase in fundic gland type gastric adenocarcinoma. Therefore, even if gastric mucosa show no atrophy, keeping the features of this disease in mind, careful examination will be important.
