{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T10:43:22Z","timestamp":1777286602802,"version":"3.51.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To discuss the histological features, pathological types, and prognosis of gastric adenocarcinoma with mucinous differentiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Specimens of 189 cases of gastric adenocarcinoma with mucinous differentiation were collected for detailed histomorphology, immunohistochemistry, fluorescence <jats:italic>in situ<\/jats:italic> hybridization, and follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In accordance with the morphological and histological structural features of the cancer cells as well as the area ratio of the mucus, gastric adenocarcinoma with mucinous differentiation was divided into four types, namely pure mucinous carcinoma, intraductal papillary mucinous carcinoma, signet ring cell type mucinous carcinoma, and mixed cell type mucinous carcinoma. Based on the macroscopic types according to Bormann's classification, pure mucinous carcinoma was mostly Type I, intraductal papillary mucinous carcinoma was mostly Type II, signet ring cell type mucinous carcinoma was mostly Type IV, and mixed cell type mucinous carcinoma was mostly Type III. The 5-year survival rate was 69.2, 64.2, 0, and 31.5%, respectively. There was a statistical difference in the lymph node metastasis rate and survival rate of the four carcinoma types. The invasion features of pure mucinous carcinoma entailed penetrating corrosively in a push-in form, without blood vessel or lymphatic metastasis and with few lymphocytes and lymphatic nodules in the marginal area. Thus, there was little lymph node metastasis and invasion of nerves. The HER2 protein expression rate was 40.2% (76\/189), the HER2 gene amplification detected by FISH technology was 16.9% (32\/189).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The independent histological type, four subtypes, and histopathological classification of gastric mucinous adenocarcinoma are important for the prognosis evaluation and precise treatment of this disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.829702","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T06:29:12Z","timestamp":1646375352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Research on the Histological Features and Pathological Types of Gastric Adenocarcinoma With Mucinous Differentiation"],"prefix":"10.3389","volume":"9","author":[{"given":"Nian-Long","family":"Meng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-kun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Ling","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-nan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3748\/wjg.v22.i3.1190","article-title":"Genomic and epigenomic heterogeneity in molecular subtypes of gastric cancer","volume":"22","author":"Lim","year":"2016","journal-title":"World J Gastroenterol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2818","DOI":"10.3748\/wjg.v24.i26.2818","article-title":"Biomarkers of gastric cancer: current topics and future perspective","volume":"24","author":"Matsuoka","year":"2018","journal-title":"World J Gastroenterol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/978-3-319-50520-6_12","article-title":"Pathogenesis of gastric cancer: genetics and molecular classification","volume":"400","author":"Figueiredo","year":"2017","journal-title":"Curr Top Microbiol Immunol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1159\/000473881","article-title":"Heterogeneity in gastric cancer: from pure morphology to molecular classifications","volume":"85","author":"Gullo","year":"2018","journal-title":"Pathobiology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma: an attempt at a histoclinical classification","volume":"64","author":"Laur\u00e9n","year":"1965","journal-title":"Acta Pathol Microbiol Scand."},{"key":"B6","volume-title":"World Health Organization Classification of Tumours of the Digestive System.","author":"Bosman","year":"2010"},{"key":"B7","article-title":"WHO Classification of Tumours of the Digestive System","author":"Odze","year":"2019"},{"key":"B8","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1111\/den.13059","article-title":"Undifferentiated-type component mixed with differentiated-type early gastric cancer is a significant risk factor for endoscopic non-curative resection","volume":"30","author":"Horiuchi","year":"2018","journal-title":"Dig Endosc."},{"key":"B9","first-page":"S2239253X19031438","article-title":"Gastric mixed adeno-neuroendocrine carcinoma with a large cell neuroendocrine component: a case reports","volume":"8","author":"Sert","year":"2019","journal-title":"Ann Ital Chir."},{"key":"B10","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1002\/jso.23484","article-title":"The relevance of the Siewert classification in the era of multimodal therapy for adenocarcinoma of the gastro-oesophageal junction","volume":"109","author":"Curtis","year":"2014","journal-title":"J Surg Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/path.4761","article-title":"Comprehensive mutation profiling of mucinous gastric carcinoma","volume":"240","author":"Rokutan","year":"2016","journal-title":"J Pathol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"289","DOI":"10.2739\/kurumemedj.43.289","article-title":"Mucinous adenocarcinoma of the stomach-clinicopathological studies","volume":"43","author":"Koufuji","year":"1996","journal-title":"Kurume Med J."},{"key":"B13","doi-asserted-by":"publisher","first-page":"176","DOI":"10.4132\/jptm.2016.08.17","article-title":"Mucinous carcinoma with extensive signet ring cell differentiation: a case report","volume":"51","author":"Kim","year":"2017","journal-title":"J Pathol Transl Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1755-8166-4-14","article-title":"Assessment of ERBB2 and EGFR gene amplification and protein expression in gastric carcinoma by immunohistochemistry and fluorescence in situ hybridization","volume":"4","author":"Wang","year":"2011","journal-title":"Mol Cytogenet."},{"key":"B15","doi-asserted-by":"publisher","first-page":"4680","DOI":"10.3748\/wjg.v21.i15.4680","article-title":"Human epidermal growth factor receptor 2 expression in mixed gastric carcinoma","volume":"21","author":"Wang","year":"2015","journal-title":"World J Gastroenterol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"439","DOI":"10.3233\/CBM-170671","article-title":"Methods and significance of the combined detection of HER2 gene amplification and chemosensitivity in gastric cancer","volume":"21","author":"Wang","year":"2018","journal-title":"Cancer Biomark."},{"key":"B17","first-page":"864","volume-title":"Geschwulste des Margens. Handbuch Spez Pathol Anat Und Hist.","author":"Borrmann","year":"1926"},{"key":"B18","first-page":"296","article-title":"Gastric tumor pathology","volume-title":"Digestive Oncology.","author":"Wang","year":"2012"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e56766","DOI":"10.1371\/journal.pone.0056766","article-title":"Cathepsin E is a marker of gastric differentiation and signet-ring cell carcinoma of stomach: a novel suggestion on gastric tumorigenesis","volume":"8","author":"Konno-Shimizu","year":"2013","journal-title":"PLoS ONE."},{"key":"B20","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s10120-012-0149-2","article-title":"Establishment and characterization of novel gastric signet-ring cell and non signet-ring cell poorly differentiated adenocarcinoma cell lines with low and high malignant potential","volume":"16","author":"Murakami","year":"2013","journal-title":"Gastric Cancer."},{"key":"B21","doi-asserted-by":"publisher","first-page":"9478","DOI":"10.1038\/s41598-021-89099-2","article-title":"The genomic landscape of carcinomas with mucinous differentiation","volume":"11","author":"Nguyen","year":"2021","journal-title":"Sci Rep."},{"key":"B22","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12957-016-0886-5","article-title":"Clinicopathological characteristics and outcomes in stage I-III mucinous gastric adenocarcinoma: a retrospective study at a single medical center","volume":"14","author":"Hsu","year":"2016","journal-title":"World J Surg Oncol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s12253-017-0283-6","article-title":"Prognosis of signet ring cell carcinoma of the colon and rectum and their distinction of mucinous adenocarcinoma with signet ring cells. A comparative study","volume":"24","author":"Pozos-Ochoa","year":"2018","journal-title":"Pathol Oncol Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/cjp2.00001","article-title":"The molecular background of mucinous carcinoma beyond MUC2","volume":"1","author":"Hugen","year":"2014","journal-title":"J Pathol Clin Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s13048-015-0169-8","article-title":"Persistent low expression of hZip1 in mucinous carcinomas of the ovary, colon, stomach and lung","volume":"8","author":"Desouki","year":"2015","journal-title":"J Ovarian Res."},{"key":"B26","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1159\/000064583","article-title":"Clinicopathologic features of mucinous gastric carcinoma","volume":"19","author":"Lim","year":"2002","journal-title":"Dig Surg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"695","DOI":"10.4103\/0028-3886.149416","article-title":"Cerebral venous sinus thrombosis: an unusual initial presentation of mucinous adenocarcinoma of stomach","volume":"62","author":"Jena","year":"2014","journal-title":"Neurol India."},{"key":"B28","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/03007995.2016.1239192","article-title":"Comparison of clinicopathological and prognostic characteristics in patients with mucinous carcinoma and signet ring cell carcinoma of the stomach","volume":"33","author":"Bozkaya","year":"2017","journal-title":"Curr Med Res Opin."},{"key":"B29","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.gie.2019.03.022","article-title":"A survival guide to HER2 testing in gastric\/gastroesophageal junction carcinoma","volume":"90","author":"Subasinghe","year":"2019","journal-title":"Gastrointest Endosc."},{"key":"B30","doi-asserted-by":"publisher","first-page":"E400","DOI":"10.3390\/cancers12020400","article-title":"Emerging targeted therapies for HER2 positive gastric cancer that can overcome trastuzumab resistance","volume":"12","author":"Mitani","year":"2020","journal-title":"Cancers."},{"key":"B31","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1080\/15384047.2017.1414759","article-title":"Correlation of trastuzumab-based treatment with clinical characteristics and prognosis in HER2-positive gastric and gastroesophageal junction cancer: a retrospective single center analysis","volume":"19","author":"Ilhan-Mutlu","year":"2018","journal-title":"Cancer Biol Ther."},{"key":"B32","doi-asserted-by":"publisher","first-page":"139","DOI":"10.5230\/jgc.2019.19.e18","article-title":"History of esophagogastric junction cancer treatment and current surgical management in Western Countries","volume":"19","author":"Berlth","year":"2019","journal-title":"J Gastric Cancer."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.829702\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T06:29:19Z","timestamp":1646375359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.829702\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":32,"alternative-id":["10.3389\/fmed.2022.829702"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.829702","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]},"article-number":"829702"}}