On the origin of gastric tumours: analysis of a case with intramucosal gastric carcinoma and oxyntic gland adenoma
On the origin of gastric tumours: analysis of a case with intramucosal gastric carcinoma and oxyntic gland adenoma
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论胃肿瘤的起源：粘膜内胃癌合并泌酸腺瘤一例分析
DOI：
10.1002/path.6050
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Seno Hiroshi
中科院分区：
文献类型：
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作者：
Kumagai Ken;Shimizu Takahiro;Nikaido Mitsuhiro;Hirano Tomonori;Kakiuchi Nobuyuki;Takeuchi Yasuhide;Minamiguchi Sachiko;Sakurai Takaki;Teramura Mari;Utsumi Takahiro;Hiramatsu Yukiko;Nakanishi Yuki;Takai Atsushi;Miyamoto Shin'ichi;Ogawa Seishi;Seno Hiroshi
大多数胃癌发生于幽门螺杆菌感染引起的胃粘膜炎症，通常伴有化生改变。然而，胃癌的起源仍不清楚。在此，我们报告一例粘膜内胃癌（IGC）和氧合腺腺瘤（OGA）源于表达痉挛的多肽化生（SPEM）。我们在一位71岁的老年妇女的上体部发现早期胃癌伴息肉。幽门感染，经内镜切除。组织学检查显示IGC和OGA均以MUC6表达为主。有趣的是，富含MUC6阳性黏液细胞（SPEM）的胃腺在它们之间扩张。全外显子组测序分析显示IGC、OGA和SPEM中存在截断kras （G12D）突变。此外，在IGC中发现了tp53和cdkn2突变以及染色体17p的缺失，而在OGA中观察到aGNASmutation。这些结果表明IGC和OGA起源于kras‐突变的SPEM。©2023英国和爱尔兰病理学会。
Most gastric cancers develop in inflamed gastric mucosa due toHelicobacter pyloriinfection, typically with metaplastic changes. However, the origins of gastric cancer remain unknown. Here, we present a case of intramucosal gastric carcinoma (IGC) and oxyntic gland adenoma (OGA) derived from spasmolytic polypeptide‐expressing metaplasia (SPEM). Early gastric cancer adjacent to a polyp was found in the upper corpus of a 71‐year‐old woman withoutH. pyloriinfection and was endoscopically resected. Histological examination showed IGC and OGA, both of which had predominant MUC6 expression. Interestingly, gastric glands with enriched MUC6‐positive mucous cells, referred to as SPEM, expanded between them. Whole‐exome sequencing analysis revealed a truncatingKRAS(G12D) mutation in IGC, OGA, and SPEM. In addition,TP53andCDKN2Amutations and a loss of chromosome 17p were found in the IGC, whereas aGNASmutation was observed in the OGA. These results indicated that IGC and OGA originated from theKRAS‐mutated SPEM. © 2023 The Pathological Society of Great Britain and Ireland.