Gastric Hamartomatous Polyps—Review and Update

Vyas, Monika; Yang, Xiu; Zhang, Xuchen

doi:10.4137/cgast.s38452

Cited by 28 publications

(20 citation statements)

References 83 publications

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“…While awaiting results of genetic testing, the initial clinicopathological information from the proband can be used to aid differential diagnosis of other gastric polyposis syndromes: for example, hamartomatous polyps in Peutz– Jeghers, juvenile polyposis, or Cowden syndrome are distinct from FGPs with dysplasia due to their disorganized growth of tissue and initially benign character. However, securing a diagnosis of the underlying GI polyposis syndrome based on morphological characteristics of gastric polypectomy specimens alone is unlikely; for example, histopathological differences of gastric hamartomatous polyps among GI polyposis syndromes are difficult to diagnose, have a low diagnostic accuracy (41% for juvenile polyposis and 54% for Peutz–Jeghers syndrome), and in general, do not allow to distinguish the underlying genetic syndrome without any genetic or clinical corroboration 8,9. Distinctive features reported for Peutz–Jeghers polyps are a cytoarchitectural pattern of pits and glands grouped or packeted together with intervening septations of smooth muscle strands not connected to the muscularis mucosa and an unremarkable lamina propria mucosae, whereas juvenile polyps more frequently have an overall disorganized pit and gland architecture with varying cystic glands and form spherical, club-shaped, or irregular villiform structures due to overgrowth of an edematous lamina propria with a mononuclear inflammatory cell infiltrate 8,9.…”

Section: Diagnosismentioning

confidence: 99%

Gastric adenocarcinoma and proximal polyposis of the stomach: diagnosis and clinical perspectives

Rudloff

2018

CEG

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Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) is a recently described, rare gastric polyposis syndrome. It is characterized by extensive involvement of the fundus and body of the stomach with fundic gland polyps sparing the antrum and lesser curvature, an autosomal dominant inheritance pattern with incomplete penetrance, and a significant predisposition for the development of gastric adenocarcinoma. Due to the recent discovery of APC promotor IB mutations (c.-191T>C, c.-192A>G, and c.-195A>C), which reduce binding of the transcription factor Yin Yang 1 (YY1) and transcriptional activity of the promotor, as its underlying genetic perturbation, GAPPS has been added to the growing molecular class of APC-associated disorders. Recent reports on family members afflicted by gastric polyposis due to GAPPS have described the development of metastatic cancer or the presence of invasive gastric adenocarcinoma in total gastrectomy specimens after variable periods of endoscopic surveillance emphasizing the need for an improved understanding of the to-date poorly characterized natural history of the syndrome. There are, however, currently no guidelines on screening, timing of prophylactic gastrectomy, or endoscopic surveillance for GAPPS available. In this review, we summarize the clinical, pathological, and genetic aspects of GAPPS as well as management approaches to this rare cancer predisposition syndrome, highlighting the need for early recognition, a multidisciplinary approach, and the creation of prospective family registries and consensus guidelines in the near future.

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Section: Diagnosismentioning

confidence: 99%

Gastric adenocarcinoma and proximal polyposis of the stomach: diagnosis and clinical perspectives

Rudloff

2018

CEG

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“…Helicobacter pylori (H. pylori) infection can cause an in ammatory reaction of the mucosa, and a polyp may form due to overgrowth of cells during the recovery period [16,17] . In fact, hyperplastic polyps are by-products of the damaged mucosa during its healing [18] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

zheng¹,

wen²,

Dai³

et al. 2020

Preprint

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Background:According to the study population, incidence of gastric polyps (GPs) varies from 0.33% to 6.7% in various studies. Most GPs consist of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Despite the high malignant APs potential, sporadic FGPs has no malignant potential. On the contrary, HPs has a lower risk of potential harm. It is not sufficient to perform biopsies to determine the presence of polyp types and displacements, therefore, some polyps may require extensive biopsy or complete resection. MethodsThis retrospective study included GPs patients or polyphenic lesions with polyps or malignant histology found in polyps or gastroscopy at the Department of Gastroenterology, Shaanxi Hospital of Traditional Chinese Medicine from 2017 to 2019.ResultsIn a series of 10.000 upper gastrointestinal endoscopy, 384 patients (3.84%) were found to have GPs. Of these patients, 98 (25.5) were male and 286(74.5) were female. The average age of the patients was 62.8±10.4 (36-75) years. HPs, APs and FGPs frequencies were 88.5%, 5.2% and 2.1%, respectively. The polyp size of 274 (71.3%) patients was ≤ 1 cm. Polyp was identified in 262 (68.2%) patients. The most common polyps are the antrum and the corpus. Endoscopic mucosal resection was performed on 128 patients. Bleeding events have been observed and endoscopic treatment is required after ESP.Conclusion: In current study, GPs frequency was low (3.84%), and HP frequency may be high due to high frequency of Helicobacter pylori (HPy) infection in China. Due to the high frequency of HPy infection and the short-term use of proton pump use, FGP frequency may be low.

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“…In another study of 900 EGD procedures, GPs were found in 126 (1.4%) patients. Histological examination revealed 48 patients with HPs, 17 with GFPs, six with APs, and 118 had gastritis or normal histology [17] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

zheng¹,

wen²,

Dai³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: According to the study population, incidence of gastric polyps (GPs) varies from 0.33% to 6.7% in various studies. Most GPs consist of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Despite the high malignant APs potential, sporadic FGPs has no malignant potential. On the contrary, HPs has a lower risk of potential harm. It is not sufficient to perform biopsies to determine the presence of polyp types and displacements, therefore, some polyps may require extensive biopsy or complete resection. Methods: This retrospective study included GPs patients or polyphenic lesions with polyps or malignant histology found in polyps or gastroscopy at the Department of Gastroenterology, Shaanxi Hospital of Traditional Chinese Medicine from 2017 to 2019.Results: In a series of 10.000 upper gastrointestinal endoscopy, 384 patients (3.84%) were found to have GPs. Of these patients, 98 (25.5) were male and 286(74.5) were female. The average age of the patients was 62.8±10.4 (36-75) years. HPs, APs and FGPs frequencies were 88.5%, 5.2% and 2.1%, respectively. The polyp size of 274 (71.3%) patients was ≤ 1 cm. Polyp was identified in 262 (68.2%) patients. The most common polyps are the antrum and the corpus. Endoscopic mucosal resection was performed on 128 patients. Bleeding events have been observed and endoscopic treatment is required after ESP.Conclusion: In current study, GPs frequency was low (3.84%), and HP frequency may be high due to high frequency of Helicobacter pylori (HPy) infection in China. Due to the high frequency of HPy infection and the short-term use of proton pump use, FGP frequency may be low.

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Gastric Hamartomatous Polyps—Review and Update

Cited by 28 publications

References 83 publications

Gastric adenocarcinoma and proximal polyposis of the stomach: diagnosis and clinical perspectives

Gastric adenocarcinoma and proximal polyposis of the stomach: diagnosis and clinical perspectives

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

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