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Papp V, Miheller P. Chronic active and atrophic gastritis as significant contributing factor to the development of gastric cystica profunda. World J Gastroenterol 2024; 30:2308-2310. [PMID: 38813049 PMCID: PMC11130573 DOI: 10.3748/wjg.v30.i17.2308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/20/2024] [Accepted: 04/15/2024] [Indexed: 04/30/2024] Open
Abstract
Gastric cystica profunda (GCP) is an uncommon but underestimated gastric lesion. Its precancerous potential determines its significance. In addition to previous mucosa injury due to operations, biopsy or polypectomy, chronic active and atrophic gastritis may also lead to the development of GCPs. By carefully examining the stomach and taking biopsy samples from the susceptible regions, the stage of atrophy can be determined. Chronic atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs formation. GCPs frequently occur close to early gastric cancers (EGCs) or EGC can arise from the cystic glands. Endoscopic resection is an effective and minimally invasive treatment in GCP.
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Affiliation(s)
- Veronika Papp
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest 1082, Hungary
| | - Pál Miheller
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest 1082, Hungary
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2
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Jiang W, Bai L, Zhang S, Cheng R. Endoscopic submucosal dissection (ESD) for gastritis cystica profunda (GCP) with early gastric cancer: A propensity score matching analysis. Heliyon 2024; 10:e29349. [PMID: 38601641 PMCID: PMC11004393 DOI: 10.1016/j.heliyon.2024.e29349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024] Open
Abstract
Background and aim Cystic dilatation of the gastric glands within the mucosal layer is the hallmark of the rare condition known as gastritis cystica profunda (GCP). Although it has been proved that GCP is the precursor lesion for early gastric cancer (EGC), the management strategy of GCP-related EGC is not well established.The purpose of this research was to determine if ESD is effective and safe for GCP-related EGC. Methods Patients with EGC who had ESD at Beijing Friendship Hospital between January 2015 and May 2023 were retrospectively included. All patients were divided into two groups: those with GCP-related EGC, and those with EGC alone. The two groups were matched 1:1 using the propensity score matching (PSM) method. Curative resection rate, postoperative adverse outcome rate (bleeding, perforation, stricture), and recurrence rate were the primary measures used to evaluate the efficacy and safety of ESD. Results There were a total of 386 participants (44 with GCP and 342 with EGC alone). Following PSM, 44 patients were paired and analyzed separately. Except for the presence of cysts in EUS (multiple/single/none cyst: 12/2/5 versus 1/0/25, P < 0.0001), there was no change in baseline characteristics, EUS appearance, or histology results between groups. Overall, there was no significant difference in curative resection rates between the GCP group (70.5 %) and the control group (81.8 %) (P = 0.211). Postoperative complications were comparative (9/44 vs 5/44, P = 0.244), as were rates of local recurrence (1/44 vs 0/44, P = 1.0), metachronous gastric cancer (1/44 vs 0/44, P = 1.0), and mortality (0/44 vs 0/44, P = 1.0). Conclusions Existence of cysts in EUS is a characteristic presentation to distinguish GCP-related EGC from EGC-alone lesions. ESD might be a safe and effective therapy for patients with GCP-related EGC.
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Affiliation(s)
| | | | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, 100050, PR China
| | - Rui Cheng
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, 100050, PR China
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3
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De Stefano F, Graziano GMP, Viganò J, Mauro A, Peloso A, Peverada J, Fellegara R, Vanoli A, Faillace GG, Ansaloni L. Gastritis Cystica Profunda: A Rare Disease, a Challenging Diagnosis, and an Uncertain Malignant Potential: A Case Report and Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1770. [PMID: 37893488 PMCID: PMC10608487 DOI: 10.3390/medicina59101770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023]
Abstract
Gastritis cystica profunda (GCP) has been defined as a rare submucosal benign gastric lesion with cystic gland growth. Due to its unclear etiopathogenesis, this lesion is often misdiagnosed and mistaken for other gastric masses. Currently, a standardized treatment for GCP lesions is still missing. Here, we illustrate a case of a patient admitted to our general surgery department for melena and general discomfort. No history of peptic ulcer or gastric surgery was present. Upper GI endoscopy was performed, showing a distal gastric lesion with a small ulceration on the top. CT-scan and endoscopic ultrasound confirmed the presence of the lesion, compatible with a gastric stromal tumor, without showing any eventual metastasis. Surgical gastric resection was performed. Histological findings were diagnostic for GCP, with cistically ectasic submucosal glands, chronic inflammation, eosinophilic infiltration and foveal hyperplasia. GCP is a very exceptional cause of upper-GI bleeding with specific histological features. Its diagnosis as well as its therapy are challenging, resulting in several pitfalls. Even though it is a rare entity, GCP should always be considered in the differential diagnosis of gastric submucosal lesions.
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Affiliation(s)
- Francesca De Stefano
- Department of Surgery, Ospedale Citta’ di Sesto San Giovanni, 20099 Sesto San Giovanni, Italy; (F.D.S.); (G.G.F.)
| | - Giorgio M. P. Graziano
- University of Pavia, 27100 Pavia, Italy; (G.M.P.G.); (J.P.); (R.F.); (L.A.)
- Department of General Surgery I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Jacopo Viganò
- Department of General Surgery I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Aurelio Mauro
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Andrea Peloso
- Visceral Surgery Division, Organ Transplantation Division, University Hospitals of Geneva, Department of Surgery, University of Geneva, 1205 Geneva, Switzerland;
| | - Jacopo Peverada
- University of Pavia, 27100 Pavia, Italy; (G.M.P.G.); (J.P.); (R.F.); (L.A.)
- Department of General Surgery I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Raffaele Fellegara
- University of Pavia, 27100 Pavia, Italy; (G.M.P.G.); (J.P.); (R.F.); (L.A.)
- Department of General Surgery I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Alessandro Vanoli
- Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy;
| | - Giuseppe G. Faillace
- Department of Surgery, Ospedale Citta’ di Sesto San Giovanni, 20099 Sesto San Giovanni, Italy; (F.D.S.); (G.G.F.)
| | - Luca Ansaloni
- University of Pavia, 27100 Pavia, Italy; (G.M.P.G.); (J.P.); (R.F.); (L.A.)
- Department of General Surgery I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
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4
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Vartanoglu Aktokmakyan T, Tokocin M, Bugdayci N, Tokocin O, Cay T, Gunes A, Solmaz A, Gulcicek OB, Celik A, Celebi F. Metabolic and Histopathological Effects of Mini Gastric By-Pass: An Experimental Animal Model. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2021.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Merve Tokocin
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Nihat Bugdayci
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Onur Tokocin
- Department of Emergency Surgery, Kagithane State Hospital, Istanbul, Turkey
| | - Tugce Cay
- Department of Pathology, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Aysegul Gunes
- Department of Biochemistry, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ali Solmaz
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Osman Bilgin Gulcicek
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Atilla Celik
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Fatih Celebi
- Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey
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5
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Wang R, Lu H, Yu J, Huang W, Li J, Cheng M, Liang P, Li L, Zhao H, Gao J. Computed tomography features and clinical characteristics of gastritis cystica profunda. Insights Imaging 2022; 13:14. [PMID: 35072798 PMCID: PMC8786983 DOI: 10.1186/s13244-021-01149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background The diagnostic evidence of gastritis cystica profunda (GCP) are not adequately described due to its extremely low morbidity. This study aimed to analyze and summarize the comprehensive CT features and clinical characteristics of patients with GCP. Results Nineteen patients were enrolled, including eight men and eleven women, with a mean age of 55.53 years. Only one patient had the history of gastric polypectomy. Among the nineteen cases, two cases were in the gastric cardia, four in the gastric fundus, eight in the gastric body and five in the gastric antrum. The shapes were sphere in thirteen patients, hemisphere in five patients and diffuse in one patient. The mean size of eighteen local lesions was 1.63 cm. The cystic changes in submucosa were detected in fifteen patients. Compared with the pancreas, most GCP lesions were hypo-attenuated on unenhanced CT (n = 8), in arterial phase (AP) (n = 17) and venous phase (VP) (n = 11). Fifteen patients had the peak enhancement in VP and two in AP. The rim-like enhancement with central low attenuation was clearly observed in thirteen patients. For the GCP accompanied by adenocarcinoma, the enhancement peak was present in AP and the gradual expansion of enhancement area was in VP. All patients underwent surgical or endoscopic resection. Sixteen cases had remission of symptoms and no recurrence. Conclusions The careful analysis of CT features and clinical characteristics can provide support for deepening the understanding of the GCP. However, a more accurate diagnosis depends on histopathological features.
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Yoshikawa M, Kinoshita H, Nishimura N, Takai R, Matsuda T, Nakatani S, Shioyama E, Takeda K, Yoshiji H. A surgically treated case of severe upper gastrointestinal hemorrhage with gastritis cystica polyposa. BMC Gastroenterol 2021; 21:27. [PMID: 33435862 PMCID: PMC7805200 DOI: 10.1186/s12876-020-01595-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Gastritis cystica polyposa (GCP) is a recently recognized entity histologically characterized by hyperplasia and cystic dilatation of the gastric glands spreading through the submucosal layer. Its symptoms include those affecting the upper gastrointestinal tract, such as upper abdominal pain, nausea, and anorexia, although some patients might be asymptomatic. GCP rarely causes severe hemorrhage. Recently, we encountered a GCP case that exhibited severe hemorrhage. Case presentation A 53 year-old man visited the emergency department complaining of hematemesis. He underwent distal gastrectomy and Billroth II reconstruction for duodenal ulcers 32 years ago. Upper gastrointestinal endoscopy detected bleeding from the reddened mucosa at the anastomosis; thus, tentative endoscopic hemostasis was conducted. Despite medical treatment with transfusion, melena with significant hemodynamic impairment persisted. He was treated again with endoscopic hemostasis and interventional radiology (IVR) but remained unresponsive to these procedures. He eventually underwent partial resection of the anastomosis site with Roux-en-Y reconstruction and finally achieved excellent postoperative recovery. Histopathological examination of the resected specimen suggested a GCP bleeding. Conclusions GCP can indeed cause severe hemorrhage. Hemorrhage caused by GCP may not respond to endoscopic hemostasis or IVR; therefore, surgical treatment should be decided without delay.
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Affiliation(s)
- Masaaki Yoshikawa
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan.
| | - Hiroki Kinoshita
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Naoki Nishimura
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Rieko Takai
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Takuya Matsuda
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Satoshi Nakatani
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Erika Shioyama
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Kosuke Takeda
- Department of Internal Medicine, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Nara Prefecture, 636-0302, Japan
| | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Kashihara, Nara Prefecture, 634-8522, Japan
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7
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Itami H, Morita K, Nakai T, Uchiyama T, Sugimoto S, Sasaki S, Matsuoka M, Myojin T, Nitta Y, Okabe F, Fujii T, Hatakeyama K, Mitoro A, Sho M, Ohbayashi C. Gastritis cystica profunda is associated with aberrant p53 and Epstein-Barr virus in gastric cancer: A clinicopathological, immunohistochemical and in situ hybridization study. Pathol Int 2020; 71:42-50. [PMID: 33084164 DOI: 10.1111/pin.13039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
Gastritis cystica profunda (GCP) is a lesion characterized by cystic gastric glands within the submucosa. Some studies have reported that GCP is a precancerous lesion. Here, we investigated the association between GCP and gastric cancer. Gastric cancer specimens were taken from 1432 patients undergoing surgery or endoscopic submucosal resection and were classified as GCP or non-GCP. The clinicopathological features, immunohistochemistry and in situ hybridization expression of p53, Ki-67, KCNE2, Epstein-Barr virus (EBV) and programmed death ligand 1 (PD-L1) were compared between the two groups, as well as between GCPs and normal pyloric glands. One hundred and eighty patients (12.6%) had GCPs. In the GCP group, no cancerous lesions were found within the GCPs, but 13% were linked to GCPs and 60.2% were located above or near GCPs. Aberrant p53 expression, EBV-positive cancer cells and PD-L1 scores were significantly higher in the GCP group. The p53 score and Ki-67 labelling index were significantly higher and the KCNE2 score was significantly lower in GCPs than in pyloric glands. Although we suggest GCP is paracancerous, GCP has high proliferation activity and gastric cancer with GCP is associated with aberrant p53 and EBV. GCP is associated with aberrant p53 expression and EBV.
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Affiliation(s)
- Hiroe Itami
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Kohei Morita
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Tokiko Nakai
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Tomoko Uchiyama
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Sumire Sugimoto
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Shoh Sasaki
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Minami Matsuoka
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Tomoya Myojin
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Yuji Nitta
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Fumi Okabe
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Tomomi Fujii
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Kinta Hatakeyama
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
| | - Akira Mitoro
- Department of Gastroenterology and Endocrinology, Nara Medical University, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Nara, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Nara, Japan
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8
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Kawakubo M, Komura H, Goso Y, Okumura M, Sato Y, Fujii C, Miyashita M, Arisaka N, Harumiya S, Yamanoi K, Yamada S, Kakuta S, Kawashima H, Fukuda MN, Fukuda M, Nakayama J. Analysis of A4gnt Knockout Mice Reveals an Essential Role for Gastric Sulfomucins in Preventing Gastritis Cystica Profunda. J Histochem Cytochem 2019; 67:759-770. [PMID: 31246144 PMCID: PMC6764063 DOI: 10.1369/0022155419860134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/06/2019] [Indexed: 12/04/2022] Open
Abstract
Gastric adenocarcinoma cells secrete sulfomucins, but their role in gastric tumorigenesis remains unclear. To address that question, we generated A4gnt/Chst4 double-knockout (DKO) mice by crossing A4gnt knockout (KO) mice, which spontaneously develop gastric adenocarcinoma, with Chst4 KO mice, which are deficient in the sulfotransferase GlcNAc6ST-2. A4gnt/Chst4 DKO mice lack gastric sulfomucins but developed gastric adenocarcinoma. Unexpectedly, severe gastric erosion occurred in A4gnt/Chst4 DKO mice at as early as 3 weeks of age, and with aging these lesions were accompanied by gastritis cystica profunda (GCP). Cxcl1, Cxcl5, Ccl2, and Cxcr2 transcripts in gastric mucosa of 5-week-old A4gnt/Chst4 DKO mice exhibiting both hyperplasia and severe erosion were significantly upregulated relative to age-matched A4gnt KO mice, which showed hyperplasia alone. However, upregulation of these genes disappeared in 50-week-old A4gnt/Chst4 DKO mice exhibiting high-grade dysplasia/adenocarcinoma and GCP. Moreover, Cxcl1 and Cxcr2 were downregulated in A4gnt/Chst4 DKO mice relative to age-matched A4gnt KO mice exhibiting adenocarcinoma alone. These combined results indicate that the presence of sulfomucins prevents severe gastric erosion followed by GCP in A4gnt KO mice by transiently regulating a set of inflammation-related genes, Cxcl1, Cxcl5, Ccl2, and Cxcr2 at 5 weeks of age, although sulfomucins were not directly associated with gastric cancer development.
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Affiliation(s)
- Masatomo Kawakubo
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences,
Interdisciplinary Cluster for Cutting Edge Research, Shinshu University,
Matsumoto, Japan
| | - Hitomi Komura
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Yukinobu Goso
- Department of Biochemistry, Kitasato University
Graduate School of Medical Sciences, Sagamihara, Japan
| | - Motohiro Okumura
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Yoshiko Sato
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Chifumi Fujii
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences,
Interdisciplinary Cluster for Cutting Edge Research, Shinshu University,
Matsumoto, Japan
| | - Masaki Miyashita
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Nobuhiko Arisaka
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Satoru Harumiya
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
| | - Kazuhiro Yamanoi
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences,
Interdisciplinary Cluster for Cutting Edge Research, Shinshu University,
Matsumoto, Japan
| | - Shigenori Yamada
- Division of Gastroenterology, Iiyama Red Cross
Hospital, Iiyama, Japan
| | - Shigeru Kakuta
- Research Center for Human and Environmental
Sciences, Shinshu University, Matsumoto, Japan
- Department of Biomedical Science, Graduate
School of Agricultural and Life Sciences, The University of Tokyo, Tokyo,
Japan
| | - Hiroto Kawashima
- Laboratory of Microbiology and Immunology,
Graduate School of Pharmaceutical Sciences, Chiba University, Chiba,
Japan
| | - Michiko N. Fukuda
- Tumor Microenvironment and Cancer Immunology
Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA,
USA
- Laboratory for Drug Discovery, National
Institute of Advanced Industrial Science and Technology, Tsukuba,
Japan
| | - Minoru Fukuda
- Tumor Microenvironment and Cancer Immunology
Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA,
USA
| | - Jun Nakayama
- Department of Molecular Pathology, Shinshu
University School of Medicine, Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences,
Interdisciplinary Cluster for Cutting Edge Research, Shinshu University,
Matsumoto, Japan
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9
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Dantsuka A, Ichii O, Hanberg A, Elewa YHA, Otsuka-Kanazawa S, Nakamura T, Kon Y. Histopathological features of the proper gastric glands in FVB/N-background mice carrying constitutively-active aryl-hydrocarbon receptor. BMC Gastroenterol 2019; 19:102. [PMID: 31226941 PMCID: PMC6588904 DOI: 10.1186/s12876-019-1009-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/04/2019] [Indexed: 01/02/2023] Open
Abstract
Background Aryl-hydrocarbon receptor (AhR) is a multiple ligand-activated transcription factor that has important roles in xenobiotic, physiological, or pathological functions. Transgenic mice systemically expressing constitutively-active AhR (CA-AhR) have been created to mimic activated AhR signaling in vivo. However, their detailed histopathological features are unclear. In the present study, we generated CA-AhR-expressing FVB/N mice (FVB-CA-AhR mice) and clarified their phenotypes in detail. Methods Male and female FVB-CA-AhR and wild-type mice were histopathologically examined from 6 to 33 weeks of age. Results Among the systemic organs, only the stomachs in FVB-CA-AhR mice showed pathological changes including cystic structures beneath the serosa; in addition, stomach weights increased with age. Histopathologically, cystic structures and alcian blue-positive metaplasia were observed in the mucosa of the proper gastric glands, and these two histometric parameters were positively correlated. Furthermore, proliferating cells shifted from the isthmus to the base of the glands, and parietal cells decreased. Age-related histopathological changes were clearer in females than in males. Importantly, in FVB-CA-AhR mice, intramucosal cysts developed as extramucosal cysts beneath the serosa, penetrating the lamina muscularis mucosae and the muscularis propria. Their incidence reached 100% in 28-week-old male mice and 33-week-old female mice. Extramucosal cysts contained alcian blue-, Griffonia simplicifolia lectin II-, or trefoil factor 2-positive cells, suggesting a stomach origin for the cysts and spasmolytic polypeptide-expressing metaplasia-like lesions. Conclusions Disease onset occurred earlier in FVB-CA-AhR mice than previously reported in C57BL/6-derived CA-AhR mice. Importantly, the histopathological features were partly similar with gastritis cystica profunda in humans and animals. Excessive activation of AhR signaling aggravated abnormalities in the gastric mucosa and were affected by both genetic- and sex-related factors. Electronic supplementary material The online version of this article (10.1186/s12876-019-1009-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ai Dantsuka
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan
| | - Osamu Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan
| | - Annika Hanberg
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Yaser Hosny Ali Elewa
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan.,Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Saori Otsuka-Kanazawa
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan
| | - Teppei Nakamura
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan.,Section of Biological Safety Research, Chitose Laboratory, Japan Food Research Laboratories, Bunkyo 2-3, Chitose, 066-0052, Japan
| | - Yasuhiro Kon
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan.
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10
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Gulcicek OB, Ozdogan K, Solmaz A, Yigitbas H, Altınay S, Gunes A, Celik DS, Yavuz E, Celik A, Celebi F. Metabolic and histopathological effects of sleeve gastrectomy and gastric plication: an experimental rodent model. Food Nutr Res 2016; 60:30888. [PMID: 27087477 PMCID: PMC4834363 DOI: 10.3402/fnr.v60.30888] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 01/29/2016] [Accepted: 02/18/2016] [Indexed: 12/14/2022] Open
Abstract
Introduction Obesity has recently become a major health problem, and researchers have been directed to work toward the development of surgical techniques, with new mediators playing an important role in nutrition. Gastric plication (GP) and sleeve gastrectomy (SG) have become popular recently. These are widely used techniques in bariatric surgery. Objectives In this study, we aimed to compare the efficiency of SG and GP techniques on rats. Methods Wistar-Hannover rats (n=18) were divided into three equal groups, namely SG, GP, and control. Blood samples were taken before the operation and on the 30th day after the operation. The weights of all rats were recorded both on first day and the 30th day after the operation. Serum gastrin, ghrelin, and leptin levels were also measured on the same days. For histopathological examination, gastrectomy was performed after the animals were sacrificed. Results Average weight loss was 10% for the SG group and 6.5% for the GP group. One month after the operations, the decrease in the ghrelin and leptin levels of GP and SG groups was significant compared with the levels of the control group. Gastrin levels of the SG group increased significantly compared with those of the control group. Histopathological examination revealed that there was significant decrease in the ghrelin and leptin levels of the GP and SG groups compared with those of the control group. Foveolar hyperplasia (FH), cystic glandular dilatation, and fibrosis were significantly higher in the GP and SG groups compared with the control group. Conclusion Although GP is not as effective as SG in terms of weight loss, it provides the same effectiveness in decreasing ghrelin and leptin levels. Histopathological findings revealed that FH, fibrosis, and the cystic glandular dilatation development rates were similar.
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Affiliation(s)
| | - Kamil Ozdogan
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ali Solmaz
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Hakan Yigitbas
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Serdar Altınay
- Pathology Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Aysegul Gunes
- Biochemistry Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Duygu Sultan Celik
- Veterinary Medicine, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Erkan Yavuz
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Atilla Celik
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Fatih Celebi
- General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey
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11
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Xu G, Peng C, Li X, Zhang W, Lv Y, Ling T, Zhou Z, Zhuge Y, Wang L, Zou X, Zhang X, Huang Q. Endoscopic resection of gastritis cystica profunda: preliminary experience with 34 patients from a single center in China. Gastrointest Endosc 2016; 81:1493-8. [PMID: 25686873 DOI: 10.1016/j.gie.2014.11.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 11/10/2014] [Indexed: 12/26/2022]
Affiliation(s)
- Guifang Xu
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Chunyan Peng
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Xia Li
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Weijie Zhang
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Ying Lv
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Tingsheng Ling
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zhihua Zhou
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yuzheng Zhuge
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Lei Wang
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Xiaoping Zou
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Xiaoqi Zhang
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Qin Huang
- Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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12
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Ogasawara N, Noda H, Kondo Y, Yoshimine T, Sugiyama T, Kimura M, Inoue S, Takahashi E, Sasaki M, Kasugai K. A case of early gastric cancer arising from gastritis cystica profunda treated by endoscopic submucosal dissection. Case Rep Gastroenterol 2014; 8:270-5. [PMID: 25408629 PMCID: PMC4209264 DOI: 10.1159/000368076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Gastritis cystica profunda (GCP) consists of hyperplasia and cystic dilatation of the gastric glands extending into the submucosa. It occurs in the residual stomach post surgery and in the unoperated stomach. GCP is considered a benign lesion, but there is controversy about its malignant potential. We report a case of early gastric cancer arising from GCP treated by endoscopic submucosal dissection (ESD) in a 55-year-old unoperated man. Upper gastrointestinal endoscopy revealed a 15-mm diameter submucosal tumor (SMT) in the upper corpus of the stomach. The surface had angiotelectasia and slight depression covered with normal mucosa. Neither ulceration nor erosion was seen. Narrow-band imaging endoscopy showed no abnormalities suggesting gastric cancer. Endoscopic ultrasonography visualized the internally low-echoic SMT, harboring tiny cystic lesions, mainly within the second and third layers of the gastric wall. The SMT was removed by ESD to avoid retention and allow for comprehensive diagnosis. It was diagnosed as GCP with partial well-differentiated adenocarcinoma without involvement of the lateral and deep margins, lymphatic invasion, vascular invasion and perineural invasion. The gastric epithelium comprised normal mucosa without dysplasia. ESD seems to be useful for the diagnosis of SMT, including GCP harboring gastric cancer, and avoids unnecessary surgical procedures.
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Affiliation(s)
- Naotaka Ogasawara
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hisatsugu Noda
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshihiro Kondo
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takashi Yoshimine
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomoya Sugiyama
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mikitoshi Kimura
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Satoshi Inoue
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Emiko Takahashi
- Departments of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Departments of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
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13
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Machicado J, Shroff J, Quesada A, Jelinek K, Spinn MP, Scott LD, Thosani N. Gastritis cystica profunda: Endoscopic ultrasound findings and review of the literature. Endosc Ultrasound 2014; 3:131-4. [PMID: 24955343 PMCID: PMC4064161 DOI: 10.4103/2303-9027.131041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 10/22/2013] [Indexed: 12/11/2022] Open
Abstract
Gastritis cystica profunda (GCP) is a rare pseudotumor of the stomach characterized by benign growths of deep gastric glands through the muscularis mucosae into the submucosa. We review a case of GCP in a 61-year-old patient with GCP, with emphasis on endoscopic ultrasound findings and present review of the current literature.
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Affiliation(s)
- Jorge Machicado
- Department of Internal Medicine, The University of Texas Health Science Center at Houston, Texas, USA
| | - Jennifer Shroff
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Texas, USA
| | - Andres Quesada
- Department of Pathology, The University of Texas Health Science Center at Houston, Texas, USA
| | - Katherine Jelinek
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Texas, USA
| | - Mathew P Spinn
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Texas, USA
| | - Larry D Scott
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Texas, USA
| | - Nirav Thosani
- Division of Gastroenterology, Hepatology and Nutrition, The University of Texas Health Science Center at Houston, Texas, USA ; Division of Gastroenterology, Stanford University, Stanford, California, USA
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14
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Abstract
Gastritis cystica profunda (GCP) is a rare disease that shows multiple cystic gastric glands dispersed within the submucosa of the stomach. GCP occurs most commonly in patients who have undergone previous gastric surgery and presents as subepithelial tumor or a polypoid lesion. Here, we report the case of GCP in a 79-year-old patient who had undergone Billroth II gastric resection. During upper gastrointestinal endoscopy multiple lesions like tiny holes in the mucosa were observed. Endoscopic ultrasound showed cystic structures in the gastric submucosa. Biopsies finally proved the dispersed mucosal glands in the submucosa, which are pathognomonic for GCP. So far, in all published cases, GCP presented as polypoid lesions with no mucosal damage in upper gastrointestinal endoscopy. It is for the first time that GCP has been diagnosed with cystic lesions connected to the gastric lumen with a porus in each of the cysts.
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15
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Kuwahara N, Kitazawa R, Fujiishi K, Nagai Y, Haraguchi R, Kitazawa S. Gastric adenocarcinoma arising in gastritis cystica profunda presenting with selective loss of KCNE2 expression. World J Gastroenterol 2013; 19:1314-1317. [PMID: 23483772 PMCID: PMC3587490 DOI: 10.3748/wjg.v19.i8.1314] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 12/19/2012] [Accepted: 01/21/2013] [Indexed: 02/06/2023] Open
Abstract
Gastritis cystica profunda (GCP) is a rare condition caused by ectopic entrapment of gastric glands, probably secondary to the disruption of muscularis mucosae. GCP is often associated with gastric adenocarcinoma, and loss of the KCNE2 subunit from potassium channel complexes is considered a common primary target molecule leads to both GCP and malignancy. In this study, we, for the first time, analyzed the expression of KCNE2 in surgically excised tissue from human gastric cancer associated with GCP and confirmed that reduced KCNE2 expression correlates with disease formation.
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16
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Deery S, Yates R, Hata J, Shi C, Parikh AA. Gastric Adenocarcinoma Associated with Gastritis Cystica Profunda in an Unoperated Stomach. Am Surg 2012. [DOI: 10.1177/000313481207800812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sarah Deery
- Division of Surgical Oncology Department of Surgery Vanderbilt University Medical Center Nashville, Tennessee
| | - Robert Yates
- Division of Surgical Oncology Department of Surgery Vanderbilt University Medical Center Nashville, Tennessee
| | - Jessica Hata
- Department of Pathology Vanderbilt University Medical Center Nashville, Tennessee
| | - Chanjuan Shi
- Department of Pathology Vanderbilt University Medical Center Nashville, Tennessee
| | - Alexander A. Parikh
- Division of Surgical Oncology Department of Surgery Vanderbilt University Medical Center Nashville, Tennessee
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17
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Choi MG, Jeong JY, Kim KM, Bae JM, Noh JH, Sohn TS, Kim S. Clinical significance of gastritis cystica profunda and its association with Epstein-Barr virus in gastric cancer. Cancer 2012; 118:5227-33. [PMID: 22511405 DOI: 10.1002/cncr.27541] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/09/2012] [Accepted: 02/13/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Gastritis cystica profunda (GCP) is a relatively rare disorder characterized by hyperplastic and cystic down growth of gastric glands into the submucosa. In the current study, the authors attempted to clarify the clinical and pathologic features of GCP in patients with gastric cancer. METHODS The records of 10,728 patients with gastric cancer who underwent gastric cancer surgery were reviewed. The clinicopathologic features of patients who had GCP (n = 161) were compared with the features of patients without GCP (n = 10,567). In situ hybridization to determine Epstein-Barr virus (EBV) positivity was performed in cancer tissues from patients with (n = 119) and without (n = 503) GCP. RESULTS GCP was associated significantly with older age, male gender, proximal tumor location, differentiated histology and Lauren intestinal type compared with non-GCP. GCP also was present more frequently in remnant and multiple gastric cancers. Patients who had GCP presented with earlier tumor stages in terms of depth of invasion and lymph node metastasis, and they had less lymphatic and perineural invasion than patients without GCP; however, the presence of GCP was not an independent prognostic factor. The EBV-positive rate was significantly higher in the GCP group (31.1%) than in the non-GCP group (5.8%). CONCLUSIONS Patients with gastric cancer who had GCP had clinicopathologic features that differed from the features observed in patients without GCP. GCP was associated significantly with EBV-positive gastric cancers, and its possible role as a premalignant lesion needs to be clarified.
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Affiliation(s)
- Min-Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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18
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Kim L, Kim JM, Hur YS, Shin YW, Park IS, Choi SJ, Han JY, Chu YC, Kim KH. Extended gastritis cystica profunda associated with Epstein-Barr virus-positive dysplasia and carcinoma with lymphoid stroma. Pathol Int 2012; 62:351-5. [PMID: 22524666 DOI: 10.1111/j.1440-1827.2012.02806.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a case of gastritis cystica porfunda (GCP) associated with gastric carcinoma with lymphoid stroma (CLS). There was dysplastic change in the transitional area between GCP and CLS. Epstein-Barr virus (EBV) in situ hybridization (ISH) revealed positive reaction at the dysplastic area as well as at the CLS area. Immunohistochemical staining disclosed that dysplastic epithelium was similar to GCP in CK 20, MUC5AC, and E-cadherin expression, but similar to CLS in MUC6, CEA, p53, c-erb-B2, and EBV-ISH expression. Results of the EBV-ISH suggested that EBV infection may play a role in dysplastic change.
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Affiliation(s)
- Lucia Kim
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
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19
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Short- and Long-Term Changes in Gastric Morphology and Histopathology Following Sleeve Gastrectomy in Diet-Induced Obese Rats. Obes Surg 2012; 22:634-40. [DOI: 10.1007/s11695-012-0606-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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20
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Moon SY, Kim KO, Park SH, Yoo KS, Park CH, Kim JH, Park CK, Jun SY. [Gastritis cystica profunda accompanied by multiple early gastric cancers]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2010; 55:325-30. [PMID: 20697192 DOI: 10.4166/kjg.2010.55.5.325] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Gastritis cystica profunda (GCP) is a rare disease which shows multiple cystic gastric glands within the submucosa of the stomach. GCP lesions mainly develop at the site of gastroenterostomy and exhibit benign behavior. However, there have been a number of debates over its malignant potential. Several reports have documented GCP accompanied by gastric carcinomas, but the relationship between the two conditions remains uncertain. Here we report two cases of GCP with dysplasia accompanied by synchronous multiple early gastric cancers without previous gastric surgery.
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Affiliation(s)
- Sun You Moon
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
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21
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Roepke TK, Purtell K, King EC, La Perle KMD, Lerner DJ, Abbott GW. Targeted deletion of Kcne2 causes gastritis cystica profunda and gastric neoplasia. PLoS One 2010; 5:e11451. [PMID: 20625512 PMCID: PMC2897890 DOI: 10.1371/journal.pone.0011451] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 06/13/2010] [Indexed: 01/02/2023] Open
Abstract
Gastric cancer is the second leading cause of cancer death worldwide. Predisposing factors include achlorhydria, Helicobacter pylori infection, oxyntic atrophy and TFF2-expressing metaplasia. In parietal cells, apical potassium channels comprising the KCNQ1 α subunit and the KCNE2 β subunit provide a K+ efflux current to facilitate gastric acid secretion by the apical H+K+ATPase. Accordingly, genetic deletion of murine Kcnq1 or Kcne2 impairs gastric acid secretion. Other evidence has suggested a role for KCNE2 in human gastric cancer cell proliferation, independent of its role in gastric acidification. Here, we demonstrate that 1-year-old Kcne2−/− mice in a pathogen-free environment all exhibit a severe gastric preneoplastic phenotype comprising gastritis cystica profunda, 6-fold increased stomach mass, increased Ki67 and nuclear Cyclin D1 expression, and TFF2- and cytokeratin 7-expressing metaplasia. Some Kcne2−/−mice also exhibited pyloric polypoid adenomas extending into the duodenum, and neoplastic invasion of thin walled vessels in the sub-mucosa. Finally, analysis of human gastric cancer tissue indicated reduced parietal cell KCNE2 expression. Together with previous findings, the results suggest KCNE2 disruption as a possible risk factor for gastric neoplasia.
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Affiliation(s)
- Torsten K. Roepke
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Kerry Purtell
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Elizabeth C. King
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Krista M. D. La Perle
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Daniel J. Lerner
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Geoffrey W. Abbott
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
- * E-mail:
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22
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Park CH, Park JM, Jung CK, Kim DB, Kang SH, Lee SW, Cho YK, Kim SW, Choi MG, Chung IS. Early gastric cancer associated with gastritis cystica polyposa in the unoperated stomach treated by endoscopic submucosal dissection. Gastrointest Endosc 2009; 69:e47-50. [PMID: 19243770 DOI: 10.1016/j.gie.2008.10.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Accepted: 10/19/2008] [Indexed: 01/25/2023]
Affiliation(s)
- Chung-Hwa Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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23
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24
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Yoshizawa N, Takenaka Y, Yamaguchi H, Tetsuya T, Tanaka H, Tatematsu M, Nomura S, Goldenring JR, Kaminishi M. Emergence of spasmolytic polypeptide-expressing metaplasia in Mongolian gerbils infected with Helicobacter pylori. J Transl Med 2007; 87:1265-76. [PMID: 18004396 DOI: 10.1038/labinvest.3700682] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Spasmolytic polypeptide (TFF2)-expressing metaplasia (SPEM) is observed in mucosa adjacent to human gastric cancer and in fundic glands showing oxyntic atrophy in Helicobacter felis-infected mice. Mongolian gerbils infected with Helicobacter pylori (Hp) develop goblet cell intestinal metaplasia and adenocarcinoma, but the presence of SPEM has not been studied in gerbils. We therefore have sought to examine the development of metaplastic mucosal changes in Hp-infected Mongolian gerbils. Mongolian gerbils were assigned to either uninfected controls or infected with Hp at 17 weeks of age. The animals were killed at 17, 20, 26, 31, 41 and 56 weeks of age. Stomach sections were stained using antibodies for TFF2, intrinsic factor, H/K-ATPase, BrdU and MUC2. Dual immunofluorescence staining for TFF2 with intrinsic factor and for TFF2 with MUC2 was performed. In uninfected animals, no SPEM or intestinal metaplasia was observed. Infected gerbils developed SPEM initially in the intermediate zone along the lesser curvature and subsequently spread out towards the greater curvature. In the earlier stages of infection, SPEM glands demonstrated TFF2 and intrinsic factor double staining cells. However, after 35 weeks of infection, the number of double staining SPEM cells decreased. While early in infection SPEM organized in straight glands, in the later stages of infections, SPEM glands became distorted or dilated along with the development of gastritis cystica profunda that was TFF2 positive. Goblet cell intestinal metaplasia developed only late in the infection. Dual staining for TFF2 and MUC2 showed glands containing both SPEM- and MUC2-positive goblet cell intestinal metaplasia. SPEM develops early in Hp infection in Mongolian gerbils, and alterations in gland morphology arise from SPEM glands during the course of gastric infection with goblet cell intestinal metaplasia developing subsequent to SPEM.
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Affiliation(s)
- Nao Yoshizawa
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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25
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Eun SH, Cho JY, Kim WJ, Ko BM, Hong SJ, Ryu CB, Kim JO, Lee JS, Jin SY, Lee MS, Shim CS, Kim BS. Synchronous early gastric cancer resembling submucosal tumor at the fundus. Gut Liver 2007; 1:171-4. [PMID: 20485635 DOI: 10.5009/gnl.2007.1.2.171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 10/21/2007] [Indexed: 11/04/2022] Open
Abstract
Concern about detecting gastric carcinoma in its early stages has increased the incidence of detecting multiple synchronous gastric carcinomas. Although gastric carcinomas may present with various gross features, those showing the features of submucosal tumor (SMT) are rare. We report on a case of synchronous gastric carcinomas comprising one lesion with typical features of superficial early gastric carcinoma and the other with atypical features that mimicked SMT. Even though synchronous gastric carcinoma is rare, it may be worthwhile to make a pathological diagnosis of coexisting SMT using endoscopic-ultrasound-guided fine-needle aspiration or endoscopic mucosal resection.
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Affiliation(s)
- Soo Hoon Eun
- Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
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26
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Kurland J, DuBois S, Behling C, Savides T. Severe upper-GI bleed caused by gastritis cystica profunda. Gastrointest Endosc 2006; 63:716-7. [PMID: 16564886 DOI: 10.1016/j.gie.2005.11.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2005] [Accepted: 11/15/2005] [Indexed: 01/14/2023]
Affiliation(s)
- Jayde Kurland
- Division of Gastroenterology, Naval Medical Center San Diego, San Diego, California, USA
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27
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28
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Suo M, Mukaisho KI, Shimomura A, Sugihara H, Hattori T. Thioproline prevents carcinogenesis in the remnant stomach induced by duodenal reflux. Cancer Lett 2005; 237:256-62. [PMID: 16051425 DOI: 10.1016/j.canlet.2005.06.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Revised: 05/30/2005] [Accepted: 06/06/2005] [Indexed: 10/25/2022]
Abstract
An excessive duodenal reflux induced by surgery has been widely accepted to cause gastric carcinogenesis in the remnant stomach. As one of causative factors for malignancy, N-nitroso compounds produced by enteric bacteria have been postulated. However, there is no concrete information to prove this hypothesis. This study was undertaken to elucidate the factors underlying the remnant stomach carcinogenesis, by giving thiazolidine-4-carboxylic acid (thioproline; TPRO) to the rats with duodenal reflux as a nitrite scavenger. Operated 39 animals were used, divided into 2 groups; one with a diet containing 0.5% TPRO (n=18), and the other with a diet without TPRO (n=21). Adenocarcinoma developed in 16 rats out of 21 (76.2%) of untreated rats, whereas adenocarcinoma was detected in 1 rat of the TPRO-treated rats (5.6%). TPRO thus prevented the development of gastric cancer in the remnant stomach, thereby suggesting a concern of nitroso compounds to the carcinogenesis.
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Affiliation(s)
- Masashi Suo
- Department of Pathology, Shiga University of Medical Science, Seta-tsukinowa-cho, Ohtsu, Shiga 520-2192, Japan
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29
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Oshima T, Joh T, Sasaki M, Tanida S, Itoh K, Mizoshita T, Kawade M, Ohara H, Nomura T, Itoh M. Gastric gland heterotopic in muscularis mucosa treated by endoscopic polypectomy: a case report. Gastrointest Endosc 2004; 60:664-7. [PMID: 15472707 DOI: 10.1016/s0016-5107(04)01888-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tadayuki Oshima
- Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Mukaisho KI, Miwa K, Kumagai H, Bamba M, Sugihara H, Hattori T. Gastric carcinogenesis by duodenal reflux through gut regenerative cell lineage. Dig Dis Sci 2003; 48:2153-8. [PMID: 14705821 DOI: 10.1023/b:ddas.0000004519.26201.a4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To elucidate the histogenesis of gastric stump cancer, we performed an operation in rats to make all duodenal contents flow back into the glandular stomach. The subjects were 41 rats, and sequential morphological changes of the duodenogastric stoma and the incidence of stump cancers were studied. Serial sections around the stoma were studied with mucin stains such as paradoxical concanavalin A (Con A), galactose oxidase Schiff (GOS), and high-iron diamine-Alcian blue (HID-AB). An immunohistochemical study on cell proliferation with bromodeoxyuridine (BrdU) was also done. At week 30, pyloric gland type cells positive for Con A first appeared at the base of the intestinal crypts and the fundic glands adjacent to the anastomosis. These glands became large with time, resulting in formation of cystically dilated glands. These gland cells were partially stained with GOS, and then they retained a proliferative activity. These changes seemed to resemble "gastritis cystica profunda" in human remnant stomachs. At 50 and 80 weeks, adenocarcinomas were observed in 4 of 10 rats (40.0%) and in 16 of 21 rats (76.2%), respectively. We have noted that the early change of cystic proliferation of mucous glands resembled the so-called "ulcer associated cell lineage (UACL)" described by others, but our characteristic finding was not only pyloric but also foveolar metaplasia. This pyloric-foveolar metaplasia subsequently led to development of glands with intestinal-type goblet cells, which looked like incomplete intestinal metaplasia. This sequence was different from UACL, and very recently, we proposed a concept of "gut regenerative cell lineage (GRCL); from pyloric-foveolar to with goblet cell metaplasia in regeneration," common to all parts of the gut, and the stump cancer appeared to arise from GRCL.
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Affiliation(s)
- Ken-Ichi Mukaisho
- Department of Pathology, Shiga University of Medical Science, Seta-tsukinowa-cho, Ohtsu, Shiga, 520-2192, Japan.
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Yamashita M, Hirokawa M, Nakasono M, Kiyoku H, Sano N, Fujii M, Koyama T, Yoshida S, Sano T. Gastric inverted hyperplastic polyp. Report of four cases and relation to gastritis cystica profunda. APMIS 2002; 110:717-23. [PMID: 12583438 DOI: 10.1034/j.1600-0463.2002.1101005.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Gastric inverted hyperplastic polyp (IHP) is a rare type of gastric polyp, and is characterized by downward growth of the hyperplastic mucosal components into the submucosa. To the best ofour knowledge, 16 gastric IHP cases have been described in the English literature, but the pathogenesis has not been established. We report the clinical and pathological findings of four gastric IHP cases. The lesions were mainly composed of hyperplastic foveolar-type glands with focal cystic dilatation. Pyloric type glands, endocrine cells, acinic cell metaplasia, and smooth muscle bundles were also seen as components of the polyp. Two cases (cases 1 and 4) coexisted with multifocal gastritis cystica profunda (GCP) and gastric adenocarcinoma. Case 4 furthermore exhibited an intermediate form between IHP and GCP. We suggest that IHP may be GCP associated with exaggeratedly hyperplastic and metaplastic changes. In case 4, the coexisting gastric carcinoma was mainly located in the submucosa, whilst the mucosal component was minimal. Five out of twenty reported gastric IHP cases, including our cases, coexisted with gastric adenocarcinoma. These facts would lead us to further investigate the relation between gastric IHP and carcinoma.
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Affiliation(s)
- Michiko Yamashita
- Department of Pathology, University of Tokushima School of Medicine, Tokushima, Japan.
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