Clinicopathological and endoscopic characteristics of pyloric gland adenoma

Abstract Objective To investigate the clinicopathological and endoscopic characteristics of patients with pyloric gland adenoma (PGA), as well as their prognosis. Methods Data of 30 cases from 24 patients, who had been histologically diagnosed as PGA, was retrospectively analyzed. Results Among the 24 patients, there were 15 females and 9 males, with an average age of 59 years old. Ten cases were located in the stomach, 4 in the duodenal bulb and 16 in the gallbladder. The average maximum diameter was 13.5mm and morphologically the vast majority were type 0-I. The assessment of the background mucosa identified autoimmune gastritis (AIG), Helicobacter Pylori-associated gastritis, familial adenomatous polyposis (FAP), ectopic gastric mucosa and chronic cholecystitis.Endoscopic resection was performed on the vast majority of gastric and duodenal cases, while all gallbladder PGAs underwent cholecystectomy. Histologically, 33.3% of PGAs showed high-grade dysplasia. All PGAs expressed MUC6 with co-expression of MUC5AC. Conclusions: PGAs often arose from the background of AIG, Helicobacter Pylori-associated gastritis, FAP and ectopic/metaplastic gastric mucosal epithelia. It is recommended that PGAs should be completely resected, especially if they are large or show high-grade features due to malignant potential, as endoscopic resection has been proven to be safe and effective for gastric and duodenal PGAs.