{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:37:23Z","timestamp":1791607043394,"version":"4.3.4"},"reference-count":62,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:00:00Z","timestamp":1539043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["POCI\u201001\u20100145\u2010FEDER\u2010022184"],"award-info":[{"award-number":["POCI\u201001\u20100145\u2010FEDER\u2010022184"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>Hereditary diffuse gastric cancer (<jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content>) is an autosomal dominant syndrome characterised by multigenerational diffuse gastric cancer, and is mainly caused by germline alterations in the <jats:italic><jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>1<\/jats:italic> gene. Currently, endoscopy has limited diagnostic accuracy, and total gastrectomy (<jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>) is the treatment of choice for asymptomatic <jats:italic><jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>1<\/jats:italic> carriers. In this study, we aimed to obtain a better understanding of <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> syndrome by exploring the histopathological findings of <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content> specimens from asymptomatic <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> patients. A comprehensive literature review was carried out, searching for <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>s performed in asymptomatic <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> patients. Fourteen unpublished cases, analysed in our institution, were also included. The series encompassed 174 <jats:italic><jats:styled-content style=\"fixed-case\">CDH<\/jats:styled-content>1<\/jats:italic> carriers. Preoperative endoscopic biopsies were positive in 28.3%. A macroscopic lesion was apparent in 11.7% of <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>s. Histopathological analysis revealed intraepithelial lesions and\/or intramucosal signet ring cell carcinoma in 87.9% of <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>s. When we explored the type of protocol used for handling the specimens, we found that microscopic cancer foci were detected in 95.3% of <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>s when a total\u2010embedding protocol (assessment of the totality of gastric mucosa) was applied, and only in 62.5% when no specific protocol was used (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). <jats:italic>Helicobacter pylori<\/jats:italic> infection was found in 23.4% cases. In conclusion, a thorough histopathological examination of gastric mucosa remains the gold standard for detection of cancer foci in <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> gastrectomy specimens, requiring experienced pathologists for an accurate diagnosis. A better understanding of the natural history of <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> will enable better clinical management of <jats:styled-content style=\"fixed-case\">HDGC<\/jats:styled-content> patients, particularly regarding the optimal timing for the performance of <jats:styled-content style=\"fixed-case\">TG<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/his.13715","type":"journal-article","created":{"date-parts":[[2018,7,17]],"date-time":"2018-07-17T07:51:19Z","timestamp":1531813879000},"page":"878-886","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Pathological features of total gastrectomy specimens from asymptomatic hereditary diffuse gastric cancer patients and implications for clinical management"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7114-0735","authenticated-orcid":false,"given":"Jo\u00e3o P","family":"Rocha","sequence":"first","affiliation":[{"name":"Faculty of Medicine of the University of Porto (FMUP) Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Gullo","sequence":"additional","affiliation":[{"name":"Department of Pathology Centro Hospitalar de S\u00e3o Jo\u00e3o (CHSJ) Porto Portugal"},{"name":"Department of Pathology FMUP Porto Portugal"},{"name":"Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup) Porto Portugal"},{"name":"Institute for Research Innovation in Health (i3S) University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaogang","family":"Wen","sequence":"additional","affiliation":[{"name":"Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup) Porto Portugal"},{"name":"Institute for Research Innovation in Health (i3S) University of Porto Porto Portugal"},{"name":"Department of Pathology Centro Hospitalar Vila Nova de Gaia\/Espinho Vila Nova de Gaia Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edtor","family":"Devezas","sequence":"additional","affiliation":[{"name":"Department of General Surgery CHSJ Porto Portugal"},{"name":"Department of General Surgery FMUP Porto Portugal"},{"name":"General Surgery High Risk Consultation of Digestive Tumours CHSJ Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Baptista","sequence":"additional","affiliation":[{"name":"Department of General Surgery CHSJ Porto Portugal"},{"name":"Department of General Surgery FMUP Porto Portugal"},{"name":"General Surgery High Risk Consultation of Digestive Tumours CHSJ Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Pathology FMUP Porto Portugal"},{"name":"Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup) Porto Portugal"},{"name":"Institute for Research Innovation in Health (i3S) University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Department of Pathology Centro Hospitalar de S\u00e3o Jo\u00e3o (CHSJ) Porto Portugal"},{"name":"Department of Pathology FMUP Porto Portugal"},{"name":"Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup) Porto Portugal"},{"name":"Institute for Research Innovation in Health (i3S) University of Porto Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apm.1965.64.1.31"},{"key":"e_1_2_8_4_1","first-page":"48","volume-title":"World Health Organization classification of tumours of the digestive system","author":"Lauwers GY","year":"2010"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2015-103094"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/32918"},{"key":"e_1_2_8_7_1","first-page":"287","article-title":"Familial gastric cancer","volume":"63","author":"Jones EG","year":"1964","journal-title":"N. 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