Endoscopic and pathological analysis of patients with early gastric cancer and comorbid gastritis cystica profunda

NIU Sensen; JIN Shu; CHANG Qianping; ZHOU Yubao

doi:10.3969/j.issn.1009-0460.2023.12.017

Abstract：Objective To analyze the endoscopic manifestations and clinicopathological features of patients with early gastric cancer and comorbid gastritis cystica profunda(GCP).Methods From January 2018 to March 2023,patients diagnosed and treated in our hospital with postoperative pathological confirmation as early gastric cancer and comorbid GCP were enrolled.The data of white light endoscopy,ultrasound endoscopic manifestations and clinicopathological features were summarized and analyzed.Results Among the 22 patients of early gastric cancer and comorbid GCP,there were 20 males and 2 females,with a median age of 70 years.There were 17 cases of Helicobacter pylori infection.None of them had a history of gastric surgery before the operation,with 19 cases of lesions located in the cardia and 3 cases in the gastric body.Under white light endoscopy,the main presentation was flat.Endoscopic ultrasound examination showed thickening of the first layer in 8 cases,thickening of the third layer in 7 cases,and exploration of the submucosal cystic hypoechoic area in 7 cases.All 22 cases underwent endoscopic mucosal dissection(ESD).Postoperative pathology revealed 22 cases of differentiated tubular adenocarcinoma,with 18 cases undergoing curative resection and 4 cases undergoing non curative resection.Conclusion GCP combined with early gastric cancer is more common in elderly males,with a flat appearance under endoscopy.The most common site is the cardia,and the postoperative pathology is mostly moderately differentiated tubular adenocarcinoma within the mucosa.Ultrasound endoscopic exploration of the submucosal cystic hypoechoic area is helpful in the diagnosis of early cancer combined with GCP.ESD treatment for early gastric cancer combined with GCP is safe and effective.