Abstract:
This case report presents two cases of differentiated intramucosal gastric cancer in the antrum. Both patients reported no history of Helicobacter pylori eradication therapy, and endoscopy and diagnostic tests indicated no H. pylori infection. Case 1 is a female patient in her 70s. Esophagoduodenogastroscopy (EGD) detected a depressed lesion. Adenocarcinoma was suspected; thus, endoscopic submucosal dissection (ESD) was performed to resect the lesion. The histological result was well-differentiated tubular adenocarcinoma, which predominantly demonstrated an intestinal mucin phenotype. The existence of a small elevated lesion in the same location was confirmed by reviewing the previous endoscopic record 52 months earlier. Case 2 is a male patient in his 60s in whom screening EGD detected an elevated lesion. The biopsy indicated gastric adenoma, and ESD was performed. The histological diagnosis was well-to-moderately differentiated tubular adenocarcinoma with a pure gastric phenotype. These results indicate that H. pylori-negative differentiated gastric carcinomas in the antrum occur as small elevated lesions that may gradually progress to a depressed form during a relatively long clinical course.
摘要:
该病例报告介绍了2例胃窦分化的粘膜内胃癌。两名患者均无幽门螺杆菌根除治疗史,内镜和诊断测试显示无幽门螺杆菌感染。病例1是70多岁的女性患者。食管十二指肠胃镜检查(EGD)发现了凹陷的病变。怀疑是腺癌;因此,采用内镜黏膜下剥离术(ESD)切除病灶.组织学结果为高分化管状腺癌,主要表现为肠道粘蛋白表型。通过回顾52个月前的先前内窥镜记录,证实了同一位置存在小的隆起病变。病例2是一名60多岁的男性患者,其中筛查EGD检测到病变升高。活检提示胃腺瘤,并进行ESD。组织学诊断为高分化至中分化的管状腺癌,具有纯胃表型。这些结果表明,胃窦中的幽门螺杆菌阴性分化胃癌是作为小的升高病变发生的,在相对较长的临床过程中可能逐渐发展为抑郁形式。