Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8208
Peer-review started: November 20, 2014
First decision: January 8, 2015
Revised: February 12, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: July 14, 2015
Recently, a new disease entity termed gastric adenocarcinoma of fundic gland type (GA-FG) was proposed. We treated five cases of GA-FG with endoscopic submucosal dissection. All tumors were small and located in the upper third of the stomach. Four tumors were macroscopically identified as 0-IIa and one was identified as 0-IIb. Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder. All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion. Lymphatic invasion was seen only in one case, while no venous invasion was recognized. All tumors were positive for pepsinogen-I and MUC6 by immunohistochemistry. None showed p53 overexpression, and the labeling index of Ki-67 was low in all cases. All cases have been free from recurrence or metastasis. Herein, we discussed the clinicopathological features of GA-FG in comparison with past reports.
Core tip: Recently, a new disease entity termed gastric adenocarcinoma of fundic gland type (GA-FG) was proposed. We treated five cases that were diagnosed as GA-FG with endoscopic submucosal dissection. GA-FG has characteristic findings in endoscopic and pathological examinations. For accurate and early endoscopic diagnosis of GA-FG, careful endoscopic examination and detailed pathological evaluation are important. Herein, we discussed the clinicopathological features of GA-FG in comparison with past reports.