Clinicopathological Features and Treatment Strategies for Gastric Epithelial Neoplasm of Fundic-gland Mucosa Lineage: A Multicenter Retrospective Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 400
- 试验地点
- 1
- 主要终点
- Comparison of Clinicopathological Characteristics Among Different Subtypes of GEN-FGML
研究概览
简要总结
Gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML) is a rare pathological type of gastric cancer characterized by unique endoscopic features, including specific morphology, color, and changes in the surface and vascular patterns of the lesion. Histologically, GEN-FGML is an epithelial neoplasm exhibiting gastric fundic gland differentiation. Based on cellular differentiation and submucosal invasion, it can be classified into three subtypes:
- Oxyntic gland adenoma (OGA);
- Gastric adenocarcinoma of fundic-gland type (GA-FG);
- Gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM). GA-FGM can be further subdivided into three subtypes: Type 1 (regular exposed pattern), Type 2 (disordered exposed pattern), and Type 3 (disordered non-exposed pattern).
Some studies have analyzed the clinicopathological characteristics, endoscopic features, molecular biological characteristics, treatment strategies, and prognosis of the different GEN-FGML subtypes. Generally, OGA and GA-FG present as low-grade epithelial neoplasms with a favorable prognosis, whereas GA-FGM exhibits higher rates of lymphovascular invasion and behaves as a high-grade malignant tumor.However, due to the currently limited number of reported cases, there are no international guidelines or consensus regarding the selection of treatment strategies for GEN-FGML, curative resection evaluation, and prognosis.
In this study, the investigators aim to retrospectively collect data on GEN-FGML cases from multiple centers in China and compare the clinicopathological characteristics, molecular biological features, endoscopic characteristics, treatment strategies, and patient prognosis among the different GEN-FGML subtypes.
详细描述
1. Research Background
Gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML) is a rare pathological type of gastric cancer characterized by unique endoscopic features, including specific morphology, color, and changes in the surface and vascular patterns of the lesion. In 2007, Tsukamoto et al. reported the first case of gastric adenocarcinoma with chief cell differentiation. In 2010, Ueyama et al. proposed gastric adenocarcinoma of fundic-gland type (GA-FG) as a novel variant of gastric adenocarcinoma. Subsequently, gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM) was also reported; this subtype exhibits gastric foveolar epithelial differentiation in addition to fundic gland differentiation and demonstrates more aggressive behavior.Histologically, GEN-FGML is an epithelial neoplasm exhibiting gastric fundic gland differentiation. Based on cellular differentiation and submucosal invasion, it can be classified into three subtypes:
- Oxyntic gland adenoma (OGA);
- Gastric adenocarcinoma of fundic-gland type (GA-FG);
- Gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM). GA-FGM can be further subdivided into three subtypes: Type 1 (regular exposed pattern), Type 2 (disordered exposed pattern), and Type 3 (disordered non-exposed pattern).
Some studies have analyzed the clinicopathological characteristics, endoscopic features, molecular biological characteristics, treatment strategies, and prognosis of the different GEN-FGML subtypes. Generally, OGA and GA-FG present as low-grade epithelial neoplasms with a favorable prognosis, whereas GA-FGM exhibits higher rates of lymphovascular invasion and behaves as a high-grade malignant tumor.
However, due to the currently limited number of reported cases, there are no international guidelines or consensus regarding the selection of treatment strategies for GEN-FGML, curative resection evaluation, and prognosis. Furthermore, the majority of reported cases have been described by Japanese researchers, and data on the incidence, detection rate, treatment strategies, and clinical prognosis of GEN-FGML in other countries remain scarce.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who voluntarily provided written informed consent between August 1, 2010 and August 1, 2024
- •Age ≥18 years at diagnosis
- •Confirmed diagnosis of GEN-FGML
排除标准
- •The clinicopathological data of the lesion(s) were missing
结局指标
主要结局
Comparison of Clinicopathological Characteristics Among Different Subtypes of GEN-FGML
时间窗: From enrollment to the end of treatment at 2 years
Histopathological Results\[the type of GEN-FGML:OGA, GA-FG, GA-FGM. result of immunohistochemistry(positve or negative): MUC5AC, MUC6, MUC2, CD10, p53, H+K+-ATP，Ki-67\]
Comparison of Therapeutic Approaches Among Different Subtypes of GEN-FGML
时间窗: From enrollment to the end of treatment at 2 years
Treatment Modalities(Endoscopic forceps removal, cold resection, snare electrosurgical resection, endoscopic mucosal resection, endoscopic submucosal dissection , surgical surgery）
Comparison of Prognosis Among Different Subtypes of GEN-FGML
时间窗: From enrollment to the end of treatment at 2 years
Surveillance（including Endoscopic Surveillance and Imaging Surveillance )
次要结局
- Medical of GEN-FGML Patients.(From enrollment to the end of treatment at 2 years)