[Clinicopathological characteristics of neuroendocrine cell dysplasia in gastric oxyntic gland mucosa].

To investigate the clinicopathological characteristics of neuroendocrine(NE) cell dysplasia in gastric oxyntic gland mucosa. The clinical data of the patients with gastric mucosal NE cell dysplasia who underwent endoscopic submucosal dissection or endoscopic mucosal resection treatment at Xiangcheng County People's Hospital and the 989th Hospital of the Joint Logistics Support Force from January 2011 to October 2024 were retrospectively included. The clinical and endoscopic manifestations of the patients were analyzed, and their pathological morphological characteristics were observed in combination with immunohistochemical staining. A total of 15 patients were included, aged 54 years (32-69 years), including 6 males and 9 females. There were a total of 25 lesions (4 and 3 patients with 2 and 3 lesions, respectively) lincluding 21 lesions in the gastric body (84.0%) and 4 lesions in the gastric fundus (16.0%). Paris classification: 24 cases (96.0%) were classified as 0-Ⅱa type, 1 case (4.0%) as 0-Ⅱc type, with a median lesion diameter of 11.0 mm (2.0-36.0 mm). Narrowband imaging under endoscopy showed glandular duct disorder and abnormal blood vessels, and the mucosal features were consistent with autoimmune gastritis changes. Histological examination showed intrinsic glandular atrophy accompanied by intestinal metaplasia, and NE cells in mucosal hyperplasia presented as solid micro nodules (≤150 μm), arranged in a beam or glandular pattern. Enlarged micro nodules (>150 μm), fusion, sprout, and micro infiltration foci or single-cell infiltration can be seen, as well as nodules with newly formed stroma. It can be seen that the nodules are located within the mucosal muscle or above the lamina propria. Immunohistochemistry showed positive synaptic and chromaffin in NE cells, with nodules smaller than 0.5 mm in diameter and no submucosal infiltration. Sixteen (64.0%) cases of dysplasia lesions were accompanied by G1 grade neuroendocrine tumors, with continuous cell shape and unclear boundaries between the two. Gastric NE cell dysplasia is a precursor lesion of neuroendocrine tumors, and the key to diagnosis lies in identifying interstitial infiltration.