Gastric pyloric gland adenoma: a multicentre clinicopathological study of 67 cases

胃肠病学 发育不良 内科学 医学 腺癌 癌症 腺瘤 病理
作者
Wookap Choi,Ian Brown,Tetsuo Ushiku,Masato Yozu,Namrata Setia,Amitabh Srivastava,Melanie Johncilla,Rish K. Pai,Ryan M. Gill,Masashi Fukayama,Joseph Misdraji,Gregory Y. Lauwers
出处
期刊:Histopathology [Wiley]
卷期号:72 (6): 1007-1014 被引量:35
标识
DOI:10.1111/his.13460
摘要

Aims There is limited information regarding the clinicopathological and immunohistochemical characteristics of gastric pyloric gland adenomas ( PGA s). Methods and results Sixty‐seven cases of gastric PGA from 57 patients were analysed. PGA s occurred with similar frequency in men and women (47.4 and 52.6%, respectively), with a mean age of 66 years. Most presented in the gastric body/fundus (67.2%). Fifteen cases (22.4%) developed against a background of autoimmune gastritis ( AIG ), whereas normal mucosa was seen in 35.8%. Only 16.4% (11 cases) developed in patients with a genetic predisposition, most commonly familial adenomatous polyposis. Low‐grade lesions had a mean size of 1.5 cm, while PGA s with high‐grade dysplasia ( HGD ) or adenocarcinoma had a mean size of 3.5 cm ( P < 0.001) and more commonly showed tubulovillous architecture (50.0 versus 25.6% in low‐grade dysplasia; P = 0.040). Most PGA s (61.2%) co‐expressed mucin ( MUC )5 AC and MUC 6 (mixed type), which was associated significantly with HGD or adenocarcinoma ( P = 0.013). AIG was also associated with HGD ( P = 0.027), but genetic predisposition did not correlate with the grade of dysplasia ( P = 0.793). The recurrence rate of PGA was similar for high‐ (11.8%) and low‐grade lesions (7.4%) ( P = 0.624). Conclusions The risk of HGD increases with the size of PGA , tubulovillous architecture and the presence of AIG as well as mixed immunophenotype. As the overall local recurrence rate is less than 10%, PGA s may be treated conservatively, but they should be excised completely if possible, particularly if they are large or show high‐grade features.
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