Diagnosis And Treatment Of 40 Cases Of Gastric Cystica Profunda

Background: Gastritis cystica profunda(GCP)is a relatively rare disease of the stomach.Histopathology is characterized by the growth of gastric mucosa to mucosa and submucosa with cystic dilatation.Since 1972,it has been proposed at domestic and abroad.Most of articles are case reports,and there are no multicenter clinical studies.The etiology,pathogenesis and epidemiology of GCP is still unclear.Due to its lack of specific clinical symptoms and endoscopic findings,the rate of misdiagnosis and missed diagnosis of gastritis cystica profunda is still high.There is currently no clinical guideline that makes it hard for clinicians to make an early accurate diagnosis and give a corresponding treatment when facing this disease.From the biological point of view,gastritis cystica profunda more likely a benign disease,but in recent years more and more reports have proposed its relationship with gastric cancer,some researchers believe that as a gastric cancer in precancerous conditions,some case reports suggest that gastritis cystica profunda is often coexist with gastric cancer.Which also caused our attention to gastritis cystica profunda and further research.Objective: To investigate the clinical characteristics in patient with gastritis cystica profunda(GCP)in order to improve the knowledge about GCP and promote the level of clinical diagnosis and treatment.Methods: We retrospectively analyzed 40 cases of GCP who performed by endoscopic treatment or surgery in our center from May 2013 and May 2018.Results: Among the 40 case,GCP were more commonly found in men than in women(75%),and the overall mean age was 61.2years.The most common anatomic location of GCP were the gastric cardia(32.5%)and gastric antrum(30%).The clinical symptoms were atypical and the conventional endoscopy was hard to diagnosis.The main endoscopic manifestation was O-II type(50%).Endoscopic treatment of 27 cases(67.5%),surgical treatment of 6 cases(15%),including ESD treatment of 21 cases,EMR treatment of 4 patients,postoperative pathology confirmed GCP with tumor lesions accounted for 55%,males and the Hp infection state was the risk factors for patient of GCP combined with neoplastic lesions.Conclusion: GCP occurs in middle-aged and elderly men.The etiology and pathogenesis are still unclear.The clinical manifestations of patients are atypical,and white light endoscopy fingdings is vary.GCP is not a benign lesion,it can be combined with neoplastic lesions,mostly differentiated intramucosal cancer.Gender and Hp infection are risk factors for GCP with neoplastic lesions,but the correlation between GCP and neoplastic lesions needs further study.Endoscopic treatment ESD/EMR or surgical treatment can be used regardless of whether there is a neoplastic lesion.Endoscopic treatment is a safe and effective minimally invasive treatment.