老年人胃底腺型肿瘤的临床特征分析

doi:10.3969/j.issn.1003-9198.2026.07.015

摘要/Abstract

摘要： 目的分析胃底腺型肿瘤老年患者的临床、内镜和病理学特征。方法回顾性分析2020年1月至2025年6月南京医科大学第一附属医院经内镜诊治的19例胃底腺型肿瘤老年患者的临床资料、内镜诊治、病理及免疫组化资料。结果 19例患者中男9例,女10例;年龄60~86岁;胃底腺型胃癌11例,泌酸腺腺瘤8例。19例均为单发胃底腺型肿瘤,其中8例合并胃多发息肉、胃间质瘤等胃部疾病。内镜下17例病灶位于胃上1/3,2例病灶位于胃中1/3;白光内镜下多表现为息肉样或黏膜下肿瘤样改变,巴黎分型多为0-Ⅱa或0-Ⅱb型,其中14例表面色调发红,5例呈褪色调改变。所有患者经内镜黏膜下剥离术(ESD)、内镜下黏膜切除术或活检夹除后均未见复发或转移,1例ESD术后追加外科手术治疗,术后病理阴性。免疫组化均弥漫表达黏蛋白6(MUC6)、突触素(Syn),零星表达嗜铬粒素A(CgA),Ki-67增殖指数低。结论胃底腺型肿瘤是一种罕见的特殊类型肿瘤,内镜治疗安全有效,预后较好,但目前对其认识不足,极易漏诊误诊,仍需提高对其认识和诊治能力。

关键词: 胃底腺型肿瘤, 泌酸腺腺瘤, 胃底腺型胃癌, 免疫组化, 老年人

Abstract: Objective To analyze the clinical, endoscopic and pathological characteristics of fundic gland type neoplasms in the elderly. Methods A retrospective analysis was conducted on 19 patients diagnosed with fundic gland type neoplasms from January 2020 to June 2025 at Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University. Results A total of 19 patients aged 60-86 years were enrolled in this study, including 8 cases of oxyntic gland adenoma, 11 cases of gastric adenocarcinoma of the fundic gland type. All 19 cases were single gastric fundic gland-type tumors, and 8 cases were complicated with gastric diseases such as multiple gastric polyps and gastric stromal tumors. Digestive endoscopy showed that 17 cases had lesions located at the upper 1/3 of the stomach, and 2 cases had lesions located at the middle 1/3 of the stomach. Under white-light endoscopy, most of the lesions showed polypoid or submucosal tumor-like changes. The main Paris classification was type 0-Ⅱa or 0-Ⅱb. Among them, 14 cases had a reddish surface color, and 5 cases showed a faded color change. After endoscopic submucosal dissection (ESD), endoscopic mucosal resection or biopsy forceps resection, no recurrence or metastasis was found in all patients. One patient received additional surgical treatment after ESD. No recurrence or metastasis was observed postoperatively. Immunohistochemistry showed diffuse expression of mucin 6 (MUC6) and synaptophysin (Syn), sporadic expression of chromogranin A (CgA), and a low Ki-67 proliferation index. Conclusions Fundic gland type neoplasm, is a rare and special type of tumor, for which endoscopic treatment is safe and effective, and the prognosis is relatively good. However, there is currently insufficient understanding of it, and it is very easy to be missed or misdiagnosed. Therefore, it is still necessary to improve the understanding, diagnosis and treatment of fundic gland type neoplasms.

Key words: fundic gland type neoplasms, oxyntic gland adenoma, gastric adenocarcinoma of the fundic gland type, immunohistochemistry, aged

中图分类号:

R 735.2

于泓, 阿楠, 王成帆, 何伟, 王翔, 杨沁怡. 老年人胃底腺型肿瘤的临床特征分析[J]. 实用老年医学, 2026, 40(7): 725-730.

YU Hong, A Nan, WANG Chengfan, HE Wei, WANG Xiang, YANG Qinyi. Analysis of clinical features of fundic gland type neoplasms in the elderly[J]. Practical Geriatrics, 2026, 40(7): 725-730.

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