Clinicopathological features and prognosis of gastric adenocarcinoma with enteroblastic differentiation

doi:10.4251/wjgo.121562

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 9

This Article

(0)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Oncology

ISSN

1948-5204

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article (XML)

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Sep 15, 2026; 18(9): 121562
Published online Sep 15, 2026. doi: 10.4251/wjgo.121562

Clinicopathological features and prognosis of gastric adenocarcinoma with enteroblastic differentiation

Ze-Lin Wen, Hu Ren, Peng-Hui Niu, He Fei, Ze-Feng Li, Dong-Bing Zhao

Ze-Lin Wen, Hu Ren, Peng-Hui Niu, He Fei, Ze-Feng Li, Dong-Bing Zhao, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Co-first authors: Ze-Lin Wen and Hu Ren.

Author contributions: Wen ZL and Ren H contributed equally to this manuscript and are co-first authors. Wen ZL, Ren H, Niu PH, Fei H, Li ZF and Zhao DB designed the research study; Wen ZL, Ren H, Niu PH, and Fei H performed the research and collected the data; Wen ZL, Ren H, and Niu PH analyzed the data; Wen ZL drafted the manuscript; Li ZF and Zhao DB critically revised the manuscript for important intellectual content and supervised the study; and all authors have read and approved the final manuscript.

AI contribution statement: The design, writing, data analysis, result interpretation, and chart generation of this article did not use any AI tools.

Supported by Beijing Hope Run Special Fund of Cancer Foundation of China, No. LC2022 L03.

Institutional review board statement: The study was reviewed and approved by the Ethics Committee of National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Approval No. 23/122-3864).

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at dbzhao@cicams.ac.cn.

Corresponding author: Dong-Bing Zhao, Chief Physician, Professor, Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. dbzhao@cicams.ac.cn

Received: March 27, 2026
Revised: April 17, 2026
Accepted: May 25, 2026
Published online: September 15, 2026
Processing time: 152 Days and 1.1 Hours

Abstract

BACKGROUND

Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare histological subtype of gastric cancer with unique embryonic characteristics, and its clinicopathological features and prognostic significance remain unclear to date.

AIM

To compare the clinicopathological features and survival outcomes between GAED and conventional gastric adenocarcinoma.

METHODS

A retrospective analysis was conducted on 330 patients who underwent radical gastrectomy at a single center from 2015 to 2024, including 81 GAED patients and 249 patients with conventional gastric adenocarcinoma. The clinicopathological features of the two groups were compared, and Kaplan-Meier analysis and Cox proportional hazards model were used to evaluate overall survival and progression-free survival.

RESULTS

Compared with the conventional gastric adenocarcinoma group, GAED patients had higher proportions of smoking history (25.9% vs 12.9%, P = 0.008) and drinking history (18.5% vs 8.8%, P = 0.024); lesions were mostly located in the distal stomach (51.9% vs 26.5%), and the proportion of cross-site lesions was lower (19.7% vs 39.0%; P < 0.001 for inter-group difference in tumor location); the proportion of intestinal type in Lauren classification was higher (60.0% vs 37.1%, P = 0.001), the proportion of signet ring cell features was lower (9.9% vs 28.5%, P = 0.001), and there was a difference in the distribution of HER2 scores (P = 0.012); the operation time was shorter (median 190 minutes vs 215 minutes, P = 0.002), the rates of perineural invasion (17.3% vs 36.5%, P < 0.001) and vascular tumor thrombus (11.1% vs 53.4%, P < 0.001) were lower, but the metastasis or recurrence rate was higher (45.7% vs 30.9%, P = 0.022). Kaplan-Meier analysis showed that overall survival and progression-free survival of GAED patients were significantly worse than those of patients with conventional gastric adenocarcinoma; multivariate analysis confirmed that GAED was an independent prognostic factor for both survival outcomes.

CONCLUSION

Compared with conventional gastric adenocarcinoma, GAED has unique clinicopathological features and worse survival outcomes. As an independent adverse prognostic factor, GAED patients require closer monitoring and more individualized management.

Keywords: Gastric adenocarcinoma with enteroblastic differentiation; Gastric adenocarcinoma; Prognosis; Overall survival; Progression-free survival

Core Tip: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare subtype of gastric cancer with distinct clinicopathological characteristics. In this retrospective study, GAED was associated with unique pathological features, a higher risk of recurrence or metastasis, and significantly poorer survival than conventional gastric adenocarcinoma. Notably, its adverse prognosis persisted despite lower rates of some traditional invasive pathological features. These findings suggest that GAED may represent a biologically distinct and clinically aggressive entity that requires closer follow-up and more individualized treatment strategies.