Clinicopathological features and prognosis of gastric adenocarcinoma with enteroblastic differentiation

doi:10.4251/wjgo.121562

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Sep 15, 2026; 18(9): 121562
Published online Sep 15, 2026. doi: 10.4251/wjgo.121562

Table 1 Baseline characteristics of patients with gastric adenocarcinoma with enteroblastic differentiation and conventional gastric adenocarcinoma, n (%)

Variable	Category	GAED (n = 81)	Conventional gastric adenocarcinoma (n = 249)	P value
Gender	Male	65 (80.2)	198 (79.5)	0.887
Gender	Female	16 (19.8)	51 (20.5)
Age, years	Median (range)	62 (34, 76)	60 (21, 83)	0.200
Smoking history	No	60 (74.1)	217 (87.1)	0.008^a
Smoking history	Yes	21 (25.9)	32 (12.9)
Drinking history	No	66 (81.5)	227 (91.2)	0.024^a
Drinking history	Yes	15 (18.5)	22 (8.8)
Helicobacter pylori status¹	Positive	17 (81.0)	37 (59.7)	0.077
Helicobacter pylori status¹	Negative	4 (19.0)	25 (40.3)
Tumor size, cm	Median (range)	4.1 (1.8, 7.4)	4.5 (0.7, 9.5)	0.129
Tumor location	Proximal	23 (28.4)	86 (34.5)	< 0.001^a
	Distal	42 (51.9)	66 (26.5)
	Overlapping lesions	16 (19.7)	97 (39.0)
Surgical approach	Open surgery	10 (12.3)	20 (8.0)	0.532
	Laparoscopy-assisted surgery	54 (66.7)	167 (67.1)
	Conversion to open surgery	5 (6.2)	13 (5.2)
	Total laparoscopic surgery	12 (14.8)	49 (19.7)
Surgical duration, minute	Median (range)	190 (100, 368)	215 (76, 617)	0.002^a
Blood transfusion	Yes	12 (14.8)	21 (8.4)	0.133
Blood transfusion	No	69 (85.2)	228 (91.6)
Number of metastatic lymph nodes	Median (range)	5 (0, 35)	6 (0, 31)	0.708
Number of retrieved lymph nodes	Median (range)	36 (11, 80)	36 (3, 107)	0.852
Lauren classification	Intestinal	45 (60.0)	84 (37.1)	0.001^a
	Diffuse	10 (13.3)	75 (33.5)
	Mixed	20 (26.7)	66 (29.4)
Borrmann classification	Type I	8 (13.3)	11 (6.0)	0.111
	Type II	25 (41.7)	62 (33.9)
	Type III	23 (38.3)	88 (48.1)
	Type IV	4 (6.7)	22 (12.0)
Signet-ring cell component	No	73 (90.1)	178 (71.5)	0.001^a
Signet-ring cell component	Yes	8 (9.9)	71 (28.5)
Linitis plastica	No	78 (96.3)	239 (96.0)	0.900
Linitis plastica	Yes	3 (3.7)	10 (4.0)
Differentiation	Well	0 (0.0)	13 (5.2)	0.219
	Moderate	43 (53.1)	109 (43.8)
	Poor	38 (46.9)	127 (51.0)
HER2 score	0	41 (50.6)	170 (68.3)	0.012^a
	1+	24 (29.6)	39 (15.7)
	2+	8 (9.9)	25 (10.0)
	3+	8 (9.9)	15 (6.0)
T stage	I	16 (19.8)	47 (18.9)	0.145
	II	13 (16.0)	28 (11.2)
	III	27 (33.3)	63 (25.3)
	IV	25 (30.9)	111 (44.6)
N stage	0	26 (32.1)	99 (39.8)	0.352
	I	17 (21.0)	40 (16.1)
	II	16 (19.8)	35 (14.0)
	III	22 (27.1)	75 (30.1)
Pathological TNM stage	I	21 (25.9)	60 (24.1)	0.394
	II	25 (30.9)	61 (24.5)
	III	35 (43.2)	128 (51.4)
Metastasis or recurrence	No	44 (54.3)	172 (69.1)	0.022^a
Metastasis or recurrence	Yes	37 (45.7)	77 (30.9)
Lymphatic invasion	No	26 (32.1)	85 (34.1)	0.788
Lymphatic invasion	Yes	55 (67.9)	164 (65.9)
Vascular invasion	No	33 (41.6)	111 (44.6)	0.608
Vascular invasion	Yes	48 (58.4)	138 (55.4)
Perineural invasion	No	67 (82.7)	158 (63.5)	< 0.001^a
Perineural invasion	Yes	14 (17.3)	91 (36.5)
Vascular tumor thrombus	No	72 (88.9)	116 (46.6)	< 0.001^a
Vascular tumor thrombus	Yes	9 (11.1)	133 (53.4)
Postoperative complication	No	70 (86.4)	198 (79.5)	0.192
Postoperative complication	Yes	11 (13.6)	51 (20.5)
Postoperative hospital stay, days	Median (range)	12 (4, 55)	12 (2, 55)	0.727

^aP < 0.05.

¹Helicobacter pylori is only applicable to a certain group of patients.

GAED: Gastric adenocarcinoma with enteroblastic differentiation; TNM: Tumor-node-metastasis.

Full Size Table

Table 2 Univariate and multivariate complications logistic regression of gastric cancer with or without enteroblastic differentiation in China National Cancer Center

Factors	Univariate analysis			Multivariate analysis
Factors	Odds ratio	95%CI	P value	Odds ratio	95%CI	P value
Group
GC	1.000
GAED	0.660	0.325-1.341	0.250
Gender
Female	1.000
Male	0.441	0.191-1.019	0.055
Age, year
< 40	1.000
40-65	2.471	0.311-19.622	0.392
> 65	3.628	0.450-29.233	0.226
Smoking history
No	1.000
Yes	0.614	0.263-1.435	0.260
Drinking history
No	1.000
Yes	0.491	0.167-1.441	0.196
*H. pylori*
Negative	1.000			1.000
Positive	0.451	0.240-0.848	0.013	0.402	0.208-0.779	0.006
Tumor size (cm)
< 4.0	1.000
≥ 4.0	1.707	0.957-3.042	0.070
Tumor location
Proximal	1.000			1.000
Distal	0.281	0.129-0.612	0.001	0.288	0.128-0.647	0.003
Overlapping lesions	0.705	0.377-1.317	0.272	0.717	0.368-1.400	0.330
Surgical approach
Open surgery	1.000
Laparoscopy assisted surgery	2.301	0.668-7.928	0.187
Conversion to open surgery	3.462	0.715-16.754	0.123
Total laparoscopic surgery	1.558	0.389-6.235	0.531
Surgical duration (hour)
< 3.3	1.000			1.000
≥ 3.3	1.895	1.077-3.333	0.027	1.502	0.825-2.734	0.183
Blood transfusion
No	1.000
Yes	1.180	0.489-2.869	0.707
The number of lymph nodes retrieved
< 34	1.000
≥ 34	1.127	0.649-1.958	0.671
Lauren classification
Intestinal	1.000
Diffuse	0.492	0.234-1.033	0.061
Mixed	0.970	0.512-1.840	0.926
Borrmann classification
Borrmann I	1.000
Borrmann II	0.924	0.319-2.675	0.885
Borrmann III	1.196	0.416-3.442	0.740
Borrmann IV	0.733	0.174-3.084	0.672
Signet ring
No	1.000
Yes	0.480	0.225-1.024	0.578
Linitis plastica
No	1.000
Yes	1.312	0.350-4.915	0.687
Differentiation
Poor	1.000
Well	1.710	0.971-3.014	0.063
Moderate	0.463	0.058-3.723	0.469
HER2 score
0 (-)	1.000
1 (+)	1.107	0.537-2.278	0.784
2 (++)	2.351	0.050-5.265	0.377
3 (+++)	0.448	0.101-1.994	0.292
pTNM stage
I	1			1.000
II	2.718	1.161-6.359	0.021	1.966	0.707-5.464	0.195
III	1.870	0.8776-3.990	0.106	1.085	0.370-3.178	0.882
Lymphatic invasion
No	1.000			1.000
Yes	2.172	1.123-4.204	0.021	2.337	0.927-5.891	0.072
Vascular invasion
No	1.000
Yes	1.583	0.900-2.784	0.111
Perineural invasion
No	1.000
Yes	1.656	0.929-2.953	0.087
Vascular tumor thrombus
No	1.000
Yes	1.306	0.750-2.273	0.345

CI: Confidence interval; GC: Gastric cancer; GAED: Gastric adenocarcinoma with enteroblastic differentiation; H. pylori: Helicobacter pylori; TNM: Tumor-node-metastasis.

Full Size Table

Table 3 Univariate and multivariate survival analysis between gastric adenocarcinoma with enteroblastic differentiation group and gastric cancer group in total patients

Prognostic factors	Univariate analysis¹			Multivariate analysis¹			Univariate analysis²			Multivariate analysis²
Prognostic factors	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value
Total
GC group	1.000			1.000			1.000			1.000
GAED group	1.549	1.113-2.156	0.029	1.714	1.207-2.435	0.012	1.576	1.133-2.193	0.023	1.823	1.287-5.596	0.005

¹Overall survival.

²Progression free survival.

Variables with a P value < 0.05 in univariate analysis were ultimately included in the multivariate analysis. HR: Hazard ratio; CI: Confidence interval; GC: Gastric cancer; GAED: Gastric adenocarcinoma with enteroblastic differentiation.

Full Size Table

Table 4 Univariate and multivariate survival analysis between gastric adenocarcinoma with enteroblastic differentiation group and gastric cancer group in pTNM I-III patients

Prognostic factors	Univariate analysis¹			Multivariate analysis¹			Univariate analysis²			Multivariate analysis²
Prognostic factors	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value	HR	95%CI	P value
pTNM I
GC group	1.000			1.000			1.000			1.000
GAED group	1.091	0.364-3.267	0.896	-	-	-	1.102	0.368-3.300	0.884	-	-	-
pTNM II
GC group	1.000			1.000			1.000			1.000
GAED group	0.586	0.232-1.485	0.345	-	-	-	0.593	0.234-1.498	0.354	-	-	-
pTNM III
GC group	1.000			1.000			1.000			1.000
GAED group	2.402	1.639-3.519	< 0.01	1.545	0.919-2.597	0.168	2.493	1.706-3.644	< 0.01	1.640	1.034-2.879	0.048

¹Overall survival.

²Progression free survival.

Full Size Table

Citation: Wen ZL, Ren H, Niu PH, Fei H, Li ZF, Zhao DB. Clinicopathological features and prognosis of gastric adenocarcinoma with enteroblastic differentiation. World J Gastrointest Oncol 2026; 18(9): 121562
URL: https://www.wjgnet.com/1948-5204/full/v18/i9/121562.htm
DOI: https://dx.doi.org/10.4251/wjgo.121562

Wen ZL, Ren H, Niu PH, Fei H, Li ZF, Zhao DB. Clinicopathological features and prognosis of gastric adenocarcinoma with enteroblastic differentiation. World J Gastrointest Oncol 2026; 18(9): 121562 [DOI: 10.4251/wjgo.121562]

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