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Updated: Jan 16, 2026
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Clinical and histological characteristics of gastric "crawling-type" adenocarcinoma
Bacui Zhang1, Wei Gao1, Kai Liu2
1Department of Gastroenterology, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Songjiang District, Shanghai 201600, China.
Background:
Crawling-type adenocarcinoma (CTA) is an uncommon and poorly characterised subtype of early gastric cancer, primarily reported in isolated case and series studies.
Aims:
To investigate the clinicopathological and endoscopic features of CTA.
Methods:
We retrospectively analysed 17 patients with histologically confirmed CTA. Clinical characteristics, endoscopic findings, including magnifying endoscopy with narrow-band imaging (ME-NBI) and computed tomography (CT) imaging, were evaluated. Histological features were assessed using hematoxylin-eosin (H&E) staining, and immunohistochemistry was performed to study the clinical features.
Result:
The mean age was 68.7 years; 64.7 % were male. Most patients were asymptomatic. Endoscopically, CTA appeared as flat or slightly elevated lesions with indistinct margins and brownish discolouration. ME-NBI revealed dilated, tortuous microvessels and mild microsurface irregularity, while CT showed no metastasis. Histologically, 82.4 % of tumors were confined to the mucosa, consisting of moderately differentiated tubular glands with horizontal spread, mild to moderate atypia, and preserved polarity. Characteristic "shaking-hand" or "WHY × " patterns were observed. Immunohistochemically, cytokeratin was positive in all cases. MUC5AC and MUC6 were aberrantly expressed in 70.6 % of cases, and most showed p53 overexpression.
Conclusion:
CTA is a histologically indolent but diagnostically challenging subtype of early gastric cancer. Recognition of its endoscopic and pathological features is essential for accurate diagnosis and management.
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