Diagnosis and treatment of 40 cases of gastritis cystica profunda

Objective To investigate the clinical, endoscopic and pathological features of gastritis cystica profunda (GCP). Methods A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital, School of Medicine, Shanghai Jiaotong University from May 2013 to May 2018, were included in the retrospective analysis. The clinical data such as population composition, clinical manifestations, endoscopic findings and pathological results were summarized and analyzed. Results Among the 40 patients were predominantly males (75.0%, 30/40), and the mean age of onset was 61.2 years. The most common sites were cardia (32.5%, 13/40) and gastric antrum (30.0%, 12/40). The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination. The endoscopic findings were mostly type 0-Ⅱ (50.0%, 20/40). GCP with neoplastic lesions accounted for 55% (22/40). Unconditional logistic regression analysis showed that male (P=0.013, OR=31.093, 95% CI: 2.079-464.976) and Helicobacter pylori infection (P=0.041, OR=10.225, 95% CI: 1.096-95.411) were risk factors for GCP with neoplastic lesions. Conclusion GCP commonly occurs in middle-aged and elderly men, and varies in different manifestations under white light endoscopy. GCP is not a benign lesion, but can also coexist with neoplastic lesions, which are mostly differentiated intramucosal cancer. Key words: Endoscopy, digestive system; Gastritis cystica profunda; Early gastric cancer; Endoscopic submucosal dissection