Endoscopic diagnosis and treatment of gastritis cystica profunda with early gastric cancer

Abstract

Objective To study the relationship between gastritis cystica profunda (GCP) and early gastric cancer (EGC), and to explore the diagnosis and treatment of GCP. Methods Clinical data of 17 patients, who were pathologically diagnosed as having GCP, including clinical symptoms, white light endoscopic findings, magnifying endoscopic features, EUS outcomes and histopathological characteristics were analyzed. Results All 17 patients of GCP had no specific clinical symptoms or history of gastric surgery prior to the operation. Eight lesions were located at cardiac, 4 at gastric body, 4 at gastric antrum and 1 at gastric angle. As to the morphology, 3 cases were type Ⅰ, 3 type Ⅰ+ Ⅱc, 9 type Ⅱa+ Ⅱc, 1 type Ⅱc and 1 type Ⅱb+ Ⅱc. The mean lesion size was 1.8 cm. Of 16 patients with preoperative EUS examination, 11 patients were found to have cystic changes, with the diagnostic rate being 68.8%(11/16). All 17 patients underwent ESD, 14 (82.4%, 14/17) of which were found to have EGC. Postoperative pathology confirmed low grade intraepithelial neoplasia in 3 cases, high grade intraepithelial neoplasia in 7, intramucosal carcinoma in 4, submucosal carcinoma in 3 patients. Conclusion EUS plays an important role in the diagnosis and treatment of GCP. And GCP is highly correlated with EGC, which should be managed in time. Key words: Gastroscopy; Gastritis cystica profunda; Early gastric cancer; Precancerous conditions