Recognizing Gastric Oxyntic Gland Neoplasms: Characteristic Endoscopic Appearance for Improved Detection

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Gastric oxyntic gland neoplasms (GOGNs) are rare and often lack obvious malignant endoscopic signs.
• This includes oxyntic gland adenoma (OGA), gastric adenocarcinoma of fundic gland type (GA-FG), and gastric adenocarcinoma of fundic gland mucosa type (GA-FGM).

Purpose of the Study:

• To characterize the endoscopic features of GOGNs to improve their recognition.
• To differentiate between subtypes of GOGNs based on endoscopic findings.

Main Methods:

• Retrospective analysis of 35 histologically confirmed GOGNs from upper endoscopic examinations.
• Evaluation of endoscopic features using white-light endoscopy (WLE), magnifying narrow-band imaging (NBI), and endoscopic ultrasonography (EUS).

Main Results:

• GOGNs were small (median 6 mm), often elevated (Paris 0-IIa, subepithelial-like), and located in the fundus/upper body.
• Common features included near-normal or reddish color, branching vessels, and focal pigmentation.
• NBI revealed distinct patterns for OGA/GA-FG (enlarged crypt openings, branching vessels) versus GA-FGM (demarcation line, irregular patterns).
• EUS showed mucosal layer localization with potential submucosal extension.

Conclusions:

• GOGNs typically present as small, inconspicuous elevated lesions with characteristic vascular and magnifying features.
• Awareness of these endoscopic patterns can enhance GOGN detection during routine endoscopy.
• Further research is needed to validate these findings in larger cohorts.