Gastric adenomas: Intestinal-type and gastric-type adenomas differ in the risk of adenocarcinoma and presence of background mucosal pathology

摘要: Gastric adenomas are neoplastic growths characterized by localized, polypoid proliferations of dysplastic epithelium. They frequently arise in stomachs with a background mucosal atrophy and intestinal metaplasia, higher risk adenocarcinoma elsewhere the stomach has been reported patients gastric adenomas. Additionally, some themselves demonstrate progression to infiltrating adenocarcinoma. However, previous studies have not comprehensively evaluated mucosa adenocarcinoma, particularly relation histologic classification as either intestinal-type or gastric-type. We studied 61 from 51 between 1985 2001. The were classified (containing at least focal goblet cells and/or Paneth cells), gastric-type (lined entirely mucin on PAS/alcian blue stain), indeterminate. features both (location, multiplicity, degree dysplasia, presence within polyp) surrounding (presence gastritis, adenocarcinoma). distributed equally throughout stomach, most solitary (82%), contained nine cases (14.8%). There 34 (56%) 31 patients, 25 (41%) 18 (including 10 familial adenomatous polyposis), 2 indeterminate type (3%). Intestinal-type significantly more likely than show high-grade dysplasia (p <0.0001), polyp = 0.016), metaplasia <0.000001), gastritis 0.002). Patients also separate adenocarcinomas (five vs 0 cases), although this did reach statistical significance. rarely truly "sporadic" lesions. In any individual patient complete removal adenoma should be performed, thorough biopsy is essential understand clinicopathologic context adenoma.