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. 2024 Feb 21;30(7):673-684.
doi: 10.3748/wjg.v30.i7.673.

Endoscopic features and treatments of gastric cystica profunda

Zi-Han Geng  1 , Yan Zhu  1 , Pei-Yao Fu  1 , Yi-Fan Qu  1 , Wei-Feng Chen  1 , Xia Yang  1 , Ping-Hong Zhou  2 , Quan-Lin Li  1
Affiliations

Endoscopic features and treatments of gastric cystica profunda

Zi-Han Geng et al. World J Gastroenterol. .

Abstract

Background: Gastric cystica profunda (GCP) represents a rare condition characterized by cystic dilation of gastric glands within the mucosal and/or submucosal layers. GCP is often linked to, or may progress into, early gastric cancer (EGC).

Aim: To provide a comprehensive evaluation of the endoscopic features of GCP while assessing the efficacy of endoscopic treatment, thereby offering guidance for diagnosis and treatment.

Methods: This retrospective study involved 104 patients with GCP who underwent endoscopic resection. Alongside demographic and clinical data, regular patient follow-ups were conducted to assess local recurrence.

Results: Among the 104 patients diagnosed with GCP who underwent endoscopic resection, 12.5% had a history of previous gastric procedures. The primary site predominantly affected was the cardia (38.5%, n = 40). GCP commonly exhibited intraluminal growth (99%), regular presentation (74.0%), and ulcerative mucosa (61.5%). The leading endoscopic feature was the mucosal lesion type (59.6%, n = 62). The average maximum diameter was 20.9 ± 15.3 mm, with mucosal involvement in 60.6% (n = 63). Procedures lasted 73.9 ± 57.5 min, achieving complete resection in 91.3% (n = 95). Recurrence (4.8%) was managed via either surgical intervention (n = 1) or through endoscopic resection (n = 4). Final pathology confirmed that 59.6% of GCP cases were associated with EGC. Univariate analysis indicated that elderly males were more susceptible to GCP associated with EGC. Conversely, multivariate analysis identified lesion morphology and endoscopic features as significant risk factors. Survival analysis demonstrated no statistically significant difference in recurrence between GCP with and without EGC (P = 0.72).

Conclusion: The findings suggested that endoscopic resection might serve as an effective and minimally invasive treatment for GCP with or without EGC.

Keywords: Early gastric cancer; Endoscopic features; Endoscopic resection; Endoscopy; Gastric cystica profunda.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Classification of gastric cystica profunda lesions. A: Mucosal lesion type; B: Submucosal lesion type; C: Polypoid type; D: Thickened mucosa with rough wrinkles type; E and F: Irregular mucosal lesion type in gastric cystica profunda.
Figure 2
Figure 2
Pathological images of gastric cystica profunda and gastric cystica profunda with early gastric cancer. A: Gastric cystica profunda; B: Gastric cystica profunda with early gastric cancer.
Figure 3
Figure 3
Significance of variable risk factors for gastric cystica profunda with early gastric cancer.
Figure 4
Figure 4
Survival analysis suggested that there was no statistical difference in recurrence between gastric cystica profunda groups with and without early gastric cancer (P = 0.72). GCP: Gastric cystica profunda; EGC: Early gastric cancer.
See this image and copyright information in PMC

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