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Phenotypic variations of gastric neoplasms in familial adenomatous polyposis are associated with endoscopic status of atrophic gastritis
Author(s) -
Nakano Kaoru,
Kawachi Hiroshi,
Chino Akiko,
Kita Mizuho,
Arai Masami,
Ide Daisuke,
Saito Shoichi,
Yoshimizu Shoichi,
Horiuchi Yusuke,
Ishiyama Akiyoshi,
Yoshio Toshiyuki,
Hirasawa Toshiaki,
Tsuchida Tomohiro,
Fujisaki Junko
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13512
Subject(s) - medicine , gastroenterology , familial adenomatous polyposis , atrophic gastritis , adenomatous polyposis coli , gastritis , cancer , stomach , pathology , colorectal cancer
Background and Aim Gastric neoplasms ( GN ), including gastric adenoma and carcinoma, are well known as extracolonic manifestations of familial adenomatous polyposis ( FAP ). We aimed to investigate the clinicopathological features of GN in FAP patients and to clarify their relationship with the endoscopic status of the background mucosa. Methods We analyzed the records of 39 patients who were diagnosed with FAP and underwent esophagogastroduodenoscopy between April 2005 and July 2016. Patients were divided into two groups according to atrophic gastritis ( AG ) status. Endoscopic findings of GN and background mucosa, and histopathological findings, including phenotypic expression of GN and mutation locus of adenomatous polyposis coli ( APC ) gene, were evaluated. Results Gastric neoplasms were more predominant in the AG ‐positive group than in the AG ‐negative group (6/9, 66.7% vs 7/30, 23.3%; P = 0.039). Of 36 GN detected in 13 patients, six GN in five patients were followed and 30 GN in eight patients were endoscopically resected and analyzed. GN in the AG ‐negative group frequently showed whitish color, were located in the proximal stomach, and presented the gastric immunophenotype compared to GN in the AG ‐positive group. All GN were intramucosal lesions and were curatively resected regardless of AG status. APC germline mutations were identified in 32 patients. In patients with GN , a significantly higher number of mutation loci were among exons 10–15 (codons 564–1465). Conclusion Clinicopathological characteristics and phenotypic expressions of GN in FAP patients depend on background mucosa status with or without AG . These findings are useful for detecting GN in FAP patients.