| Objective: The objective of this study is to investigate the clinicopathological characteristics of gastric adenocarcinoma of the fundic gland type,compare the metastasis and recurrence rates with other common types of gastric cancer,and analyze the difference in SP70 expression between gastric adenocarcinoma of the fundic gland type and other gastric diseases.The aim is to explore the potential significance of SP70 in the differential diagnosis of gastric adenocarcinoma of the fundic gland type and improve the understanding of the disease to reduce missed diagnosis and misdiagnosis.Methods: The study involved 13 patients with gastric adenocarcinoma of the fundic gland type as the experimental group,and40 patients as the control group with fundic gland polyps,hyperplastic polyps,atrophic gastritis,and other types of gastric adenocarcinoma.Clinicopathological data was collected through telephone follow-up or medical record system,and all paraffin blocks were subjected to section,HE staining and immunohistochemical staining of Pepsinogen-1,H+/K+-ATPase,MUC-6,SP70 and other markers.The expression of SP70 was statistically analyzed using microscopy,and SPSS28.0 software was used for data analysis,with the chi-square test verifying the differential expression results of SP70 between gastric adenocarcinoma of the fundic gland type and diseases in each control group.Results: The study collected clinicopathological data of 13 cases of gastric adenocarcinoma of the fundic gland type,including 7 males and 6females aged 43 to 68 years.All patients had tumors located in the fundus and body of the stomach,with a ki-67 index below 5% and no vascular invasion.After follow-up,patients had a good prognosis with no recurrence or metastasis.Microscopic examination found tumor cells mostly mixed with two types of oxyntic gland cells in different proportions,arranged in a labyrinth pattern with mucosal muscle invasion.Comparing the lymph node metastasis rate and recurrence rate to 40 cases of gastric adenocarcinoma,13 cases of fundic gland type adenocarcinoma had no metastasis or recurrence,while 28 and 19 cases of adenocarcinoma had metastasis and recurrence,respectively,with a statistically significant difference(P <0.05).Immunohistochemical staining revealed only one SP70 positive expression in gastric adenocarcinoma of the fundic gland type,and the rest were negative.Compared with differential diseases such as gastric fundic gland polyps,hyperplastic polyps,and atrophic gastritis,SP70 expression was decreased or lost(P<0.05).However,Pepsinogen-1,H+/K+-ATPase and MUC-6 staining showed no significant difference between gastric fundic gland type adenocarcinoma and differential diseases.Conclusion: The study found that gastric adenocarcinoma of the fundic gland type has microscopic characteristics of acidotic gland dilatation and anastomosis,mild structural atypia,and low metastasis and recurrence rates.Treatment may consist mainly of EMR and ESD,avoiding radical gastrectomy.Pepsinogen-1,H+/K+-ATPase and MUC-6 are not specific immunohistochemical markers for the diagnosis of gastric adenocarcinoma of the fundic gland type.In contrast,SP70 could serve as a potential immunohistochemical diagnostic marker. |
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