On the origin of gastric tumours: analysis of a case with intramucosal gastric carcinoma and oxyntic gland adenoma

IF 5.6 2区医学 Q1 ONCOLOGY

The Journal of Pathology Pub Date : 2023-01-10 DOI:10.1002/path.6050

Ken Kumagai, Takahiro Shimizu, Mitsuhiro Nikaido, Tomonori Hirano, Nobuyuki Kakiuchi, Yasuhide Takeuchi, Sachiko Minamiguchi, Takaki Sakurai, Mari Teramura, Takahiro Utsumi, Yukiko Hiramatsu, Yuki Nakanishi, Atsushi Takai, Shin'ichi Miyamoto, Seishi Ogawa, Hiroshi Seno

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引用次数: 1

Abstract

Most gastric cancers develop in inflamed gastric mucosa due to Helicobacter pylori infection, typically with metaplastic changes. However, the origins of gastric cancer remain unknown. Here, we present a case of intramucosal gastric carcinoma (IGC) and oxyntic gland adenoma (OGA) derived from spasmolytic polypeptide-expressing metaplasia (SPEM). Early gastric cancer adjacent to a polyp was found in the upper corpus of a 71-year-old woman without H. pylori infection and was endoscopically resected. Histological examination showed IGC and OGA, both of which had predominant MUC6 expression. Interestingly, gastric glands with enriched MUC6-positive mucous cells, referred to as SPEM, expanded between them. Whole-exome sequencing analysis revealed a truncating KRAS(G12D) mutation in IGC, OGA, and SPEM. In addition, TP53 and CDKN2A mutations and a loss of chromosome 17p were found in the IGC, whereas a GNAS mutation was observed in the OGA. These results indicated that IGC and OGA originated from the KRAS-mutated SPEM. © 2023 The Pathological Society of Great Britain and Ireland.

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胃肿瘤的起源:粘膜内胃癌和氧合腺腺瘤1例分析

大多数胃癌发生在幽门螺杆菌感染引起的发炎的胃黏膜中，通常伴有化生变化。然而，癌症的起源仍然未知。在此，我们报告了一例粘膜内胃癌（IGC）和由表达痉挛多肽的化生（SPEM）引起的氧化腺腺瘤（OGA）。在一名71岁未感染幽门螺杆菌的女性的上体中发现了与息肉相邻的早期癌症，并进行了内镜切除。组织学检查显示IGC和OGA均具有主要的MUC6表达。有趣的是，具有富集的MUC6阳性粘液细胞（称为SPEM）的胃腺在它们之间扩张。全外显子组测序分析显示IGC、OGA和SPEM中存在截短KRAS（G12D）突变。此外，在IGC中发现了TP53和CDKN2A突变以及染色体17p的缺失，而在OGA中观察到了GNAS突变。这些结果表明IGC和OGA来源于KRAS突变的SPEM。©2023大不列颠及爱尔兰病理学会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of Pathology 医学-病理学

CiteScore

14.10

自引率

1.40%

发文量

144

审稿时长

3-8 weeks

期刊介绍： The Journal of Pathology aims to serve as a translational bridge between basic biomedical science and clinical medicine with particular emphasis on, but not restricted to, tissue based studies. The main interests of the Journal lie in publishing studies that further our understanding the pathophysiological and pathogenetic mechanisms of human disease. The Journal of Pathology welcomes investigative studies on human tissues, in vitro and in vivo experimental studies, and investigations based on animal models with a clear relevance to human disease, including transgenic systems. As well as original research papers, the Journal seeks to provide rapid publication in a variety of other formats, including editorials, review articles, commentaries and perspectives and other features, both contributed and solicited.