深在性囊性胃炎临床研究进展

深在性囊性胃炎(gastritis cystica profunda, GCP)是一种临床罕见的胃黏膜下病变，因无特异性的临床症状和内镜下表现，术前明确诊断仍存在困难。既往观点多认为GCP是一种良性病变，但近年来与胃癌伴发的GCP病例报道逐渐增多，提示GCP可能与胃癌的发生发展存在一定相关性。本文从GCP的病因及发病机制、临床表现、诊断、治疗及预后，特别是与胃癌的关系等方面进行了综述，总结了GCP目前的临床研究进展，以加深临床医师对这一罕见病的理解，为GCP诊疗提供理论依据。     

内镜超声引导下细针抽吸术在深在性囊性胃炎术前诊断中的应用一例

深在性囊性胃炎（gastritis cystica profunda,GCP）是在炎性物质刺激下胃黏膜内的腺体向黏膜肌层以下生长并扩张成囊状的一种病变，该病病因与发病机制尚未明确，临床多无症状，可因非特异消化道表现就诊，严重者可出现消化道出血，实验室检查也无特异性。本文报道华中科技大学同济医学院附属同济医院诊治一例GCP患者的经验，显示内镜超声结合内镜超声引导下细针抽吸术的诊断价值。     

深在性囊性胃炎1例

深在性囊性胃炎(gastritis cystic profunda,GCP)是一种罕见的胃黏膜下病变,最早由Lettler等[1]在1972年首次发现并报道.1981 年,Franzin等[2]将其正式命名为深在性囊性胃炎(GCP),至今,国内共报道约两百例.现将天津北辰医院消化科收治的1 例GCP病例报道如下,并复习...     

深在性囊性胃炎1例

深在性囊性胃炎(gastritis cystica profunda,GCP)是一种罕见的胃黏膜下病变,多有腹痛、腹胀、食欲不振、出血、贫血等表现。胃镜检查可见胃黏膜炎症,活组织检查可无异常,超声胃镜检查可见特异性的胃壁增厚伴局部深达黏膜下层甚至固有肌层的不规则低回声区。本文结合相关文献对1例GCP患者进行报道。     

Menetrier病六例临床分析

Menetrier病是一种较罕见的肥厚性胃病，由Menetrier于1888年首先报道。关于本病的命名还不统一，如：巨大肥厚性胃炎、巨大皱襞肥厚症、胃黏膜息肉样肿胀、肥厚增生性胃炎等。本文报道我院诊治的Menetfier病6例，并结合文献复习对其发病病因、诊断及治疗进行分析。[第一段]     

酷似弥漫浸润型胃癌的深在性囊性胃炎1例

酷似弥漫浸润型胃癌的深在性囊性胃炎1例，经胃镜、CT、胃肠造影等检查均提示胃癌可能，后经超声内镜深挖活检、手术病理证实为深在性囊性胃炎。     

胰腺囊性纤维化研究进展

囊性纤维化(cysticfibrosis,CF)是欧美白种人中最常见的致死性常染色体隐性遗传病,在新生儿中发病率高达1/2000,而亚洲人和非洲黑人少见。1938年,Andersen首先报道此病并命名。CF主要影响胃肠道和呼吸系统,通常具有慢性梗阻性肺部病变,胰腺外分泌功能不足和汗液电解质异常升高的特征。本文就CF的发病机制,胰腺病变的临床表现及新近诊治进展作一综述。     

内镜窄带成像技术对疣状胃炎胃小凹分类及其临床病理价值探讨

疣状胃炎又称胃黏膜隆起性糜烂、隆起糜烂性胃炎，是一种具有特殊形态特征的胃黏膜病变，其临床表现无特征性，主要依靠胃镜诊断，目前病因未明，在病理学上存在一定比例的肠上皮化生和异型增生，部分有恶变可能。在世界第十次胃肠病大会上，已被列为胃癌前病变之。     

935例胆汁反流性胃炎临床和内镜分析

目的探讨胆汁反流性胃炎临床表现，中医证型，胃镜胃黏膜病变和幽门螺杆菌（Hp）感染的情况。方法对符合诊断的935例胆汁反流性胃炎的临床表现，中医证型，胃镜胃黏膜病理及Hp感染情况进行分析。结果935例胆汁反流性胃炎Hp感染率为36．6％，与中医证型存在一定的相关性。胆汁反流性胃炎与萎缩，肠化生等病理改变有关。结论胆汁反流性胃炎Hp感染率低于非胆汁反流性慢性胃炎。Hp感染率在脾胃湿热型及肝胃不和型较高。胆汁反流性胃炎肠化生和萎缩性病变在脾胃湿热型和肝胃不和型中较高，而异型增生的发生在脾胃虚寒型中较高。     

从病理学角度谈慢性胃炎与功能性消化不良的诊断与治疗

慢性胃炎与FD临床上两者容易造成混淆,理论上,慢性胃炎属于器质性病变,内镜下胃黏膜有糜烂或萎缩病变,病理活检表现为活动性炎症,以中性粒细胞浸润和腺上皮损害为标志;萎缩性胃炎则表现为固有腺体的减少、肠上皮化生和异型增生等。FD内镜虽也可诊断为慢性浅表性胃炎,但胃黏膜并无明显糜烂或萎缩病变;病理活检可出现淋巴细胞浸润,但并无活动性炎症和腺上皮病变等特征。掌握两种疾病在病因、诊断和治疗上的不同特点,对规范慢性胃炎和FD的诊治有重要意义。     

Large-cell neuroendocrine carcinoma arising from a gastritis cystica polyposa

Gastritis cystica polyposa is a polypoid lesion that arises from the gastric mucosa at the gastrojejunal anastomotic site and is characterized by cystic dilation of the gastric glands. A 78-year-old man who underwent distal gastrectomy for a gastric ulcer with Billroth II reconstruction approximately 40 years previously, exhibited a gastritis cystica polyposa at the anastomotic site. Ulceration was observed on an annual endoscopic examination. Endoscopic ultrasonography revealed a submucosal hypoechoic mass with multiple cystic lesions. Gastrectomy was performed and histological examination revealed a large-cell neuroendocrine carcinoma with cystic dilation of the gastric glands. Here, we report the first case of a large-cell neuroendocrine carcinoma arising from a gastritis cystica polyposa. Endoscopic ultrasonography was effective at diagnosing a submucosal hypoechoic mass with cystic dilation of the gastric glands.     

Immunohistochemical Analysis of a Case of Gastritis Cystica Profunda Associated with Carcinoma Development

We report a rare case of gastritis cystica profunda (GCP) accompanied by carcinoma that developed in a 51-year-old Japanese man without antecedent gastric surgery. The polypoid tumor was located in the upper body of the resected stomach. Histologically, it was characterized by herniation of surface epithelium and cystic glands in the submucosa, muscularis propria, and subserosa. Marked chronic atrophic gastritis was found throughout the stomach, and dysplastic epithelia and a few adenocarcinoma cells were found in the deeper parts of the GCP. The Ki-67, p53, and p21^WAF1/CIP1 labeling indices for the deeper part of the GCP were higher than those for the superficial parts or the surrounding mucosa, suggesting that both epithelial cell proliferation and p53-dependent p21^WAF1/CIP1 expression in DNA-damaged cells, which might be associated with gastritis, are enhanced in line with penetration of glands. The underlying mechanisms might be linked in a chain of factors leading to malignancy.     

Gastritis cystica profunda in a previously unoperated stomach:A case report

Gastritis cystica profunda is a relatively rare disease, usually observed at anastomotic sites in stomachs of patients that have undergone gastric procedures. We present the rare case of an elevated lesion in the anterior wall of the gastric antrum of a 43-year-old Chinese woman who had never undergone gastric surgery and had no gastrointestinal tract symptoms. Although the physical examination and laboratory data showed no abnormalities, endoscopic ultrasonography revealed an anechoic cystic structure. Abdominalcomputed tomography and magnetic resonance imaging showed the gastric wall of the greater curvature of the antrum was markedly and irregularly thickened, and mild to moderate enhancement was observed around the lesion with no enhancement in the central portion, suggestive of a gastrointestinal stromal tumor. The patient underwent a distal gastric resection of the 2.5 cm × 1.5 cm lesion. A postoperative pathologic examination showed dilated cystic glands in the muscularis mucosa and submucosal layers and erosion of the mucosal surface of the tumor, confirming the diagnosis of gastritis cystica profunda without malignancy.     

Gastric adenocarcinoma arising in gastritis cystica profunda presenting with selective loss of KCNE2 expression

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.     

Multiple early gastric cancer with gastritis cystica profunda showing various histological types

We report a case of multiple early gastric cancer showing varied histological types associated with gastritis cystica profunda (GCP). A 61-year-old man who had early gastric cancer associated with GCP underwent a distal gastrectomy with lymphadenectomy. Histological examination showed various histological types of cancer -well differentiated, moderately differentiated, poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet ring cell carcinoma- that had developed independently in the mucosal and submucosal layers of the resected specimen. Furthermore, multiple cysts with a single layer of columnar epithelium were present in the submucosa around the cancerous lesions. However, no neoplastic changes were found in those epithelial cells. Helicobacter pylori was detected in the residual stomach 3 months after surgery. Although the mechanism of the relationship between gastric carcinoma and GCPs is obscure, we speculate that repeated erosion and regeneration induced by chronic inflammation causes multicentric carcinogenesis as well as an aberration of the gastric glands. GCPs may be a risk factor for multiple gastric cancer.     

A ten-year follow-up of a case with gastric adenoma accompanied with gastritis cystica profunda treated by endoscopic submucosal dissection

Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection.     

Epstein-Barr virus-associated gastric carcinoma in the remnant stomach: de novo and metachronous gastric remnant carcinoma

Background The remnant stomach corresponds to the gastric cardia, but is exposed to a completely different environment. The present study was performed to investigate the role of Epstein-Barr virus (EBV) infection in patients with gastric remnant carcinoma (GRC).Methods Clinicopathological features, gastritis, and infection by EBV were investigated in patients with two types of GRC: GRC occurring at an interval of 10 years or longer between operations (de novo GRC group) and GRC occurring within 10 years after the initial operation for gastric carcinoma (metachronous GRC group).Results EBV involvement in the de novo GRC group (23%) was not significantly different from that in the cardia of non-remnant carcinomas (controls; 18%). EBV involvement showed greater correlations in male patients (18/63; 28%), and in those with gastritis cystica polyposa (GCP; 13/41; 31%), and those with an interval of 20 years or longer (15/50; 30%) than with the other parameters. Multivariate analysis showed a significant correlation between GCP and EBV infection. Histologically, hyperplasia or mild atrophy, and mild lymphocytic infiltration were observed in 56% and 67% of non-neoplastic mucosa of EBV-associated GRC, respectively. In the metachronous GRC group, EBV-encoded mRNA in situ hybridization (EBER-ISH) of 27 pairs of primary gastric carcinomas (GCs) and metachronous GRCs indicated that only six EBV (+) metachronous GRCs were derived from EBV (+) GC.Conclusions Epstein-Barr virus infection, together with long-standing inflammation, which causes GCP, may facilitate the development of de novo GRC. Close follow-up of patients treated with distal gastrectomy for EBV-associated GC is necessary to detect metachronous GRC.     

A case of gastritis cystica polyposa showing a characteristic endoscopic ultrasonogram

Littler reported on the torose polypoid lesion observed at the site of gastroenterostomy long after gastrectomy and called it gastritis cystica polyposa (GCP). Since then, much attention has been paid to hypertrophic lesions at the sites of gastroenterostomy, and many reports on GCP have been published. This lesion often develops in patients who had gastroenteroanastomosis. It was observed by the authors that a submucosal tumor developed at the cardiac part of the stomach in a patient who had no history of gastrectomy. Very few cases of GCP were observed in unoperated stomachs. The tumor was excised by endoscopic mucosal resection and diagnosed histopathologically as GCP. Endoscopic ultrasonography before the operation revealed the presence of a spongy body filled with anechoic areas of various sizes under the mucosa of the tumor. This finding is characteristic of this disorder and is detailed here with a discussion on related papers.     

Collagenous gastritis

In the present paper, we report a case of rare collagenous gastritis. The patient was a 25‐year‐old man who had experienced nausea, abdominal distention and epigastralgia since 2005. Esophagogastroduodenoscopy (EGD) carried out at initial examination by the patient's local doctor revealed an extensively discolored depression from the upper gastric body to the lower gastric body, mainly including the greater curvature, accompanied by residual mucosa with multiple islands and nodularity with a cobblestone appearance. Initial biopsies sampled from the nodules and accompanying atrophic mucosa were diagnosed as chronic gastritis. In August, 2011, the patient was referred to Tohoku University Hospital for observation and treatment. EGD at our hospital showed the same findings as those by the patient's local doctor. Pathological findings included a membranous collagen band in the superficial layer area of the gastric mucosa, which led to a diagnosis of collagenous gastritis. Collagenous gastritis is an extremely rare disease, but it is important to recognize its characteristic endoscopic findings to make a diagnosis.     

Gastritis cystica polyposa concomitant with gastric inflammatory fibroid polyp occurring in an unoperated stomach

The endoscopic examination of a 61-year-old male patient revealed a protruding lesion in the greater curvature of the lower third area of the stomach. The lesion, 17 mm in size, was resected completely with endoscopic submucosal dissection using an insulated-tip diathermic knife (IT-ESD). Histological examination of the protruding lesion revealed proliferation of fibroblasts and infiltration of inflammatory cells in the mucosa and submucosa, and it was diagnosed as an inflammatory fibroid polyp (IFP). Gastritis cystica polyposa (GCP) was presented adjacent to the IFP. This may be the first report of GCP concomitant with gastric IFP occurring in an unoperated stomach.