title: Gastric adenocarcinoma of the fundic gland (chief cell-predominant type): A review of endoscopic and clinicopathological features.
abstract: Gastric adenocarcinoma of the fundic gland (chief cell-predominant type, GA-FG-CCP) is a rare variant of well-differentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from the gastric mucosa of the fundic gland region without chronic gastritis or intestinal metaplasia. The majority of GA-FG-CCPs exhibit either a submucosal tumor-like superficial elevated shape or a flat shape on macroscopic examination. Narrow-band imaging with endoscopic magnification may reveal a regular or an irregular microvascular pattern, depending on the degree of tumor exposure to the mucosal surface. Pathological analysis of GA-FG-CCPs is characterized by a high frequency of submucosal invasion, rare occurrences of lymphatic and venous invasion, and low-grade malignancy. Detection of diffuse positivity for pepsinogen-I by immunohistochemistry is specific for GA-FG-CCP. Careful endoscopic examination and detailed pathological evaluation are essential for early and accurate diagnosis of GA-FG-CCP. Nearly all GA-FG-CCPs are treated by endoscopic resection due to their small tumor size and low risk of recurrence or metastasis.
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyazawa
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yano
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Arihara
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Horita
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Sakai
authors.affiliation: Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan.
authors.forename: Yatsugi
authors.initials: Y
authors.lastname: Noda
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology*; D014408:Biomarkers, Tumor; D001706:Biopsy; D019872:Chief Cells, Gastric / Q000473:pathology*; D003937:Diagnosis, Differential; D005748:Gastric Fundus / Q000166:cytology / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000379:methods; D062048:Narrow Band Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local; D020116:Pepsinogen A / Q000276:immunology; D011127:Polyps / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D020116:Pepsinogen A
keywords: Chief cell; Fundic gland; Gastric adenocarcinoma; Narrow-band imaging; Pepsinogen-I