The Clinical Features And Significance Of Gastritis Cystica Profunda

BackgroundGastritis cystica profunda(GCP),a rare disease of the stomach,has been reported on a case-by-case basis since its introduction in 1972.There are no multi-center clinical studies yet.Therefore,The epidemiology and mechanism of gastritis cystica profunda development remains unclear.The lack of corresponding clinical guidelines,clinicians in the face of this disease can not be the first time to make a diagnosis and give the corresponding treatment options.Although the biology of gastritis cystica profunda may be more consistent with the performance of a benign disease,there are many reports of its relationship with gastric cancer,more like a precancerous lesion of gastric cancer,and even some cases of gastritis cystica profunda Coexisting with gastric cancer.This has also drawn our attention to the gastritis cystica profunda.Therefore,although primary prevention against gastritis cystica profunda can not be achieved at present,tertiary prevention is also of crucial importance for the secondary prevention of the disease.At present,the misdiagnosis rate and misdiagnosis rate of gastritis cystica profunda are still high,and the research on deep cystic gastritis needs to be further studied.ObjectiveCombined with the literature,we analyzed the clinical characteristics and treatment results of 7 cases of gastritis cystica profunda,and discussed the diagnosis and treatment of gastritis cystica profunda.MethodsMethods the clinical data of 7 patients with GCP diagnosed and treated in the First Affiliated Hospital of Zhengzhou University from November 2013 to November 2017 were retrospectively analyzed.The clinical manifestations,auxiliary examination results,treatment and pathological characteristics were analyzed.ResultsAll 7 patients had no history of gastric surgery and family history of related diseases.No obvious abnormality was observed in laboratory examination.There were 4 cases of abdominal pain,2 cases of abdominal distension,1 case of choking,2 cases of insufficiency,1 case of nausea and vomiting.Six patients with endoscopic ultrasonography showed single uplift and inhomogeneous echo in some parts.The lesion was located in 4 cases of gastric antrum,located in 2 cases in the stomach and 1 case in the bottom of the stomach.Five patients with enhanced CT scan showed no obvious enhancement in the arterial phase of the disease,and the inhomogeneous enhancement of the venous phase.One case indicated thickening of the stomach wall,and 4 cases showed nodular protrusion to the stomach cavity.Among the 7 patients,3 underwent local excision of surgery,3 endoscopic submucosa dissection(ESD)and 1 endoscopic mucosal resection(EMR).In the postoperative pathology,1 case combined with low-grade intraepithelial neoplasia,1 case with ectopic pancreas,1 patient with the involvement of muscularis propria.The risk of male patients with high-grade intraepithelial neoplasia or early gastric cancer is higher than that of female patients.ConclusionGastritis cystica profunda clinical manifestation has no obvious specificity,CT combined ultrasonic gastroscopy can offer reference for diagnosis and preoperative evaluation of lesions in smaller scale without breaking the submucosa feasible endoscopic treatment,for the involvement of muscular layer and below or associated with malignant patients,surgical treatment.At the same time,postoperative patients should be closely followed up,especially male patients.We should be alert to canceration.