The white ring sign is useful for differentiating between fundic gland polyps and gastric adenocarcinoma of the fundic gland type.

Autor:	Takahashi K; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Sasaki T; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Ueno N; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Maguchi H; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Tachibana S; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Hayashi R; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Kobayashi Y; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Sugiyama Y; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Sakatani A; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Ando K; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Kashima S; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Moriichi K; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Tanabe H; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Harada K; Gastroenterology, Harada Hospital, Asahikawa, Japan., Yuzawa S; Department of Diagnostic Pathology, Asahikawa Medical University, Asahikawa, Japan., Ichihara S; Department of Surgical Pathology, Sapporo Kosei General Hospital, Sapporo, Japan., Okumura T; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan., Fujiya M; Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2024 Jun 06; Vol. 12 (6), pp. E723-E731. Date of Electronic Publication: 2024 Jun 06 (Print Publication: 2024).
DOI:	10.1055/a-2301-6248
Abstrakt:	Background and study aims Gastric adenocarcinoma of the fundic gland type (GA-FG) is characterized by an elevated lesion with vessel dilation exhibiting branching architecture (DVBA). However, this feature is also found in fundic gland polyps (FGPs), posing a challenge in their differentiation. In this study, we aimed to investigate the clinicopathological features of gastric elevated lesions with DVBA and assess the efficacy of the white ring sign (WRS) as a novel marker for distinguishing between FGPs and GA-FGs. Methods We analyzed 159 gastric elevated lesions without DVBA and 51 gastric elevated lesions with DVBA, further dividing the latter into 39 in the WRS-positive group and 12 in the WRS-negative group. The clinicopathological features, diagnostic accuracy, and inter-rater reliability were analyzed. Results Univariate and multivariate analyses for gastric elevated lesions with DVBA identified the histological type consistent with FGPs and GA-FGs, along with the presence of round pits in the background gastric mucosa, as independent predictors. FGPs were present in 92.3% (36/39) of the WRS-positive group and GA-FGs were observed in 50.0% (6/12) of the WRS-negative group. WRS positivity and negativity exhibited high diagnostic accuracy, with 100% sensitivity, 80.0% specificity, and 94.1% accuracy for FGPs, and 100% sensitivity, 86.7% specificity, and 88.2% accuracy for GA-FGs. Kappa values for WRS between experts and nonexperts were 0.891 and 0.841, respectively, indicating excellent agreement. Conclusions WRS positivity and negativity demonstrate high diagnostic accuracy and inter-rater reliability for FGPs and GA-FGs, respectively, suggesting that WRS is a useful novel marker for distinguishing between FGPs and GA-FGs. Competing Interests: Conflict of Interest Mikihiro Fujiya received lecture fees from Olympus Corporation. The remaining authors have no conflict of interest to declare. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu