Endoscopy 2018; 50(04): S77-S78
DOI: 10.1055/s-0038-1637257
ESGE Days 2018 oral presentations
21.04.2018 – Stomach: Improving diagnosis
Georg Thieme Verlag KG Stuttgart · New York

THE CLINICOPATHOLOGICAL FEATURES OF GASTRIC NEOPLASMS IN PATIENTS WITH FAP

K Nakano
1   Cancer Institute Hospital Ariake, Gastroenterology, Tokyo, Japan
,
A Chino
1   Cancer Institute Hospital Ariake, Gastroenterology, Tokyo, Japan
,
M Arai
2   Cancer Institute Hospital Ariake, Gene Oncology, Tokyo, Japan
,
H Kawachi
3   Cancer Institute Hospital Ariake, Pathology, Tokyo, Japan
,
A Ishiyama
1   Cancer Institute Hospital Ariake, Gastroenterology, Tokyo, Japan
,
S Saito
1   Cancer Institute Hospital Ariake, Gastroenterology, Tokyo, Japan
,
J Fujisaki
1   Cancer Institute Hospital Ariake, Gastroenterology, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

In familial adenomatous polyposis (FAP), fundic gland polyp (FGP), adenoma and adenocarcinoma (AC) are recognized as extracolonic manifestations in the stomach. Despite the lack of concrete evidence, Helicobacter pylori infection is believed to affect gastric neoplasm development in FAP. Here, we examined the clinicopathological features of gastric neoplasms in patients with FAP.

Methods:

We enrolled 39 patients with FAP who underwent esophagogastroduodenoscopy from April 2005 to July 2016. Patients were categorized into two groups: (1) atrophic gastritis present (AG+) and (2) absent (AG–); the prevalence of FGP and gastric AC was studied. For 21 gastric ACs detected in 7 patients, endoscopic findings, curativity for endoscopic resection (ER).

Besides, 11 representative lesions, from 21 ACs, with typical histology were selected, and immunohistochemistry was performed for phenotypic analysis.

Results:

Gastric FGP and ACs were 10% (1/10) and 60% (6/10), respectively, in the AG+ group, and 82% (24/29) and 7% (2.29), respectively, in the AG– group. Gastric ACs were significantly more frequent in the AG+ group than in the AG- group (P < 0.001). All 21 AC lesions were treated using curative ER. Among 4 gastric ACs in the AG– group, 3 lesions (75%) were elevated type, and all lesions appeared white by white light endoscopy. Meanwhile, among 17 ACs in the AG+ group, 9 lesions (53%) were of the depressed type, and two-third of the lesions were reddish in color.

As per phenotypic analysis, the pure gastric phenotype was found only in ACs in the AG– group, and mixed/pure intestinal phenotypes were only found in the AG+ group.

Conclusions:

In patients with FAP, FGP mainly developed in the AG– group, and gastric ACs occurred more frequently in the AG+ group. Macroscopic type, color, and phenotype of ACs varied by AG status.