Endoscopic Findings and Treatment of Gastric Neoplasms in Familial Adenomatous Polyposis

Sato, Chihiro; Takahashi, Kazuya; Sato, Hiroki; Naruse, Takumi; Nakajima, Nobuhito; Takatsuna, Masafumi; Mizuno, Ken‐ichi; Hashimoto, Satoru; Takeuchi, Manabu; Yokoyama, Junji; Kobayashi, Masaaki; Terai, Shuji

doi:10.5230/jgc.2022.22.e30

Cited by 2 publications

(1 citation statement)

References 47 publications

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“…Within the different types of gastric polyps in FAP patients, intGA are of particular interest because of their increased risk for gastric cancer development. Evidence from the literature suggests that the incidence of intGA is variable, ranging from 1.3% to 15.4% in several Western FAP cohorts [2,[20][21][22][23][24][25][26][27][28][29] and from 14.2% to 66.7% in Asian FAP cohorts [8,9,15,[30][31][32][33][34]. The distinct gastric phenotype in WFP and AFP can be explained by geographic differences, heterogeneity of patient cohorts, and, most importantly, by the higher prevalence of HP infection in AFP.…”

Section: Discussionmentioning

confidence: 99%

Gastric Polyps in Familial Adenomatous Polyposis Portuguese Patients: The First Western Cohort with Asian Features

Baptista,

Fernandes,

Garrido

et al. 2023

Pathobiology

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Introduction: Chronic atrophic gastritis may contribute to gastric polyps (GP) phenotype in familial adenomatous polyposis (FAP). Considering the high prevalence of Helicobacter-pylori (HP) infection in Portugal, we aim to characterise GP in a series of Portuguese patients. Methods: In a retrospectively-selected series of 53 FAP patients, clinical data and histopathological features of GP and background gastric mucosa were studied. SPSS (27.0) was used for statistical analysis. Results: Thirteen patients (24.5%) developed fundic gland polyps (FGP), seven (13.2%) gastric adenomas (GA) and ten (18.9%) both FGP and GA. Out of 100 GP, four were hyperplastic polyps, 58 FGP (24 with dysplasia), 35 intestinal-type GA (intGA) and three foveolar-type GA (fovGA). IntGA were larger (60% >7mm, p=0.03), occurred predominantly in the distal stomach (66.7%, p=0.024), in patients harbouring gastric intestinal metaplasia (IM) (86.7%, p<0.001) and duodenal adenomas (86.7%, p<0.001) Conclusion: This is the first Western series showing high prevalence of intGA in FAP patients, comparable to Asian cohorts. HP infection and chronic atrophic gastritis/intestinal metaplasia are likely responsible for this difference, with risk of neoplastic transformation and management implications. Biopsy/excision of GP >7mm, in the distal stomach, and in patients harbouring gastric intestinal metaplasia/duodenal adenomas should be considered.

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