Pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus

Huang, Qin; Gold, Jason S.; Shi, Jiong; Fan, Xiangshan; Wu, Hongyan; Feng, An‐Ning; Zhou, Qiang

doi:10.1016/j.humpath.2011.07.024

Cited by 10 publications

(14 citation statements)

References 30 publications

(55 reference statements)

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“…Micropapillary adenocarcinoma was defined as small pseudopapillary tumor clusters in at least 5% of the estimated tumor volume without fibrovascular cores but surrounded by empty lacuna spaces 30 . Pancreatic acinar-like adenocarcinoma was determined by the criteria described previously 38 . All tumors were graded for differentiation, according to the WHO criteria 1 .…”

Section: Methodsmentioning

confidence: 99%

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Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients

Huang

Fang

Shi

et al. 2015

Sci Rep

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Early gastric carcinoma (EGC) in Chinese patients remains poorly understood and endoscopic therapy has not been well established. Here, we compared endoscopic and clinicopathologic features between early proximal gastric carcinoma (PGC, n = 131) and distal gastric carcinoma (DGC, n = 307) in consecutive 438 EGCs diagnosed with the WHO criteria. By endoscopy, PGCs showed protruding and elevated patterns in 61.9%, while depressed and excavated patterns in 33.6%, which were significantly different from those (32.6% and 64.5%) in DGCs. PGCs were significantly smaller (1.9 cm in average, versus 2.2 cm in DGCs), invaded deeper (22.9% into SM2, versus 13% in DGCs), but had fewer (2.9%, versus 16.7% in DGCs) lymph node metastases. Papillary adenocarcinoma was significantly more frequent (32.1%, versus 12.1% in DGCs), as were mucinous and neuroendocrine carcinomas, carcinoma with lymphoid stroma (6.9%, versus 1.6% in DGCs); but poorly cohesive carcinoma was significantly less frequent (5.3%, versus 35.8% in DGCs). The overall 5-year survival rate was 92.9% in EGCs, and PGC patients showed shorter (42.4 months, versus 48.3 in DGCs) survival. Papillary and micropapillary adenocarcinomas and nodal metastasis were independent risk factors for worse survival in EGCs. EGCs in Chinese were heterogeneous with significant differences in endoscopy and clinicopathology between PGC and DGC.

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Section: Methodsmentioning

confidence: 99%

“…For pancreatic acinar-like adenocarcinoma, anti-α1-chymotrypsin antibody was utilized (polyclonal, dilution 1:100, Zymed Labs, CA). Immunoreactivity was considered positive for pancreatic acinar-like adenocarcinoma if over 10% of total target cells were stained on the same tissue section 12 38 .…”

Section: Methodsmentioning

confidence: 99%

Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients

Huang

Fang

Shi

et al. 2015

Sci Rep

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“…Using conventional methods, 3 – 5 , 22 immunohistochemistry was performed on selected cases. The antibodies used were purchased from government-approved vendors.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological characterisation of small (2cm or less) proximal and distal gastric carcinomas in a Chinese population

et al. 2015

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SummaryClinicopathological characteristics of small gastric carcinoma have not been well defined in Chinese patients. The aim of this study was to investigate and compare small proximal (PGC, n = 111) with distal (DGC, n = 202) gastric carcinoma in 313 consecutive surgically resected small (≤2 cm) gastric carcinomas diagnosed with the WHO criteria. PGC patients were significantly older (average age 63 years versus 59 in DGCs) with a male/female ratio of 3:1. Most tumours were clustered along the lesser curvature (74% in PGCs and 65% in DGCs). Compared to DGCs, PGCs showed a protruded gross pattern significantly more frequently and were significantly better differentiated with a significantly wider histomorphological spectrum. Surprisingly, PGCs were composed of significantly fewer signet-ring cell carcinomas (1% versus 16% in DGCs) but were significantly more deeply invasive, compared to DGCs. Lymph node metastasis was detected in 23% overall, but was significantly less frequent in PGCs (16%) than in DGCs (26%) (p < 0.05). However, the difference in survival between the two groups was not statistically significant. Our results demonstrate that in Chinese patients, PGCs display distinct clinicopathological characteristics, compared to DGCs.

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“…While adenocarcinoma is most common, a substantial proportion of PGC in resection cases exhibits uncommon histological types, including recently discovered entities such as pancreatic acinar‐like adenocarcinoma and gastric carcinoma with lymphoid stroma . The diversity of PGC histology is well‐known and has been documented previously in the North American and European populations . In the early studies on EAC and GEJ cancers, most tumors were large in size and frequently destroyed the GEJ landmark .…”

Section: Wide Histopathological Spectrummentioning

confidence: 98%

Recent advances in proximal gastric carcinoma

Huang

Sun

Fan

et al. 2016

J of Digest Diseases

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The American Joint Committee on Cancer (AJCC) staging scheme requires staging proximal gastric carcinoma (PGC) as esophageal adenocarcinoma (EAC), which has been shown to be controversial by recent research results. To update the current research findings on PGC, we systematically reviewed and analyzed the scientific evidence on key arguments related to PGC. The data of high-quality research articles showed that PGC arised in the cardiac mucosa in the proximal stomach within 3 cm below the gastroesophageal junction. Its incidence is rising in East Asian countries, but decreasing in the West, and plateaued at a low level in the United States. PGC is a slowly progressive cancer with unknown independent risk factors and the mechanisms of pathogenesis. This carcinoma exhibits a wide histopathological spectrum and heterogeneous post-resection patient survival characteristics, and cannot be adequately staged for prognotic stratification by the current AJCC staging classification. The results on PGC genomics reveal unique genetic profiles, especially in East Asian populations. In conclusion, mounting evidence defies a simple placement of PGC in a single category of EAC for disease classification; further investigations on the mechanisms of PGC pathogenesis are urgently needed.

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Pancreatic acinar-like adenocarcinoma of the proximal stomach invading the esophagus

Cited by 10 publications

References 30 publications

Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients

Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients

Clinicopathological characterisation of small (2cm or less) proximal and distal gastric carcinomas in a Chinese population

Recent advances in proximal gastric carcinoma

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