Gastric adenomas and their management in familial adenomatous polyposis.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
aheadofprint:
17
09
2020
pubmed:
18
9
2020
medline:
3
8
2021
entrez:
17
9
2020
Statut:
ppublish
Résumé
Patients with familial adenomatous polyposis (FAP) are at increased risk of developing gastric adenomas. There is limited understanding of their clinical course and no consensus on management. We reviewed the management of gastric adenomas in patients with FAP from two centers. Patients with FAP and histologically confirmed gastric adenomas were identified between 1997 and 2018. Patient demographics, adenoma characteristics, and management/surveillance outcomes were collected. Of 726 patients with FAP, 104 (14 %; 49 female) were diagnosed with gastric adenomas at a median age of 47 years (range 19 - 80). The median size of gastric adenomas was 6 mm (range 1.5 - 50); 64 (62 %) patients had adenomas located distally to the incisura. Five patients (5 %) had gastric adenomas demonstrating high-grade dysplasia (HGD) on initial diagnosis, distributed equally within the stomach. The risk of HGD was associated with adenoma size ( We observed gastric adenomas in 14 % of patients with FAP. Of these, 5 % contained HGD; risk of HGD correlated with adenoma size. Endoscopic resection was feasible, with few complications and low recurrence rates, but did not completely eliminate the cancer risk.
Sections du résumé
BACKGROUND
Patients with familial adenomatous polyposis (FAP) are at increased risk of developing gastric adenomas. There is limited understanding of their clinical course and no consensus on management. We reviewed the management of gastric adenomas in patients with FAP from two centers.
METHODS
Patients with FAP and histologically confirmed gastric adenomas were identified between 1997 and 2018. Patient demographics, adenoma characteristics, and management/surveillance outcomes were collected.
RESULTS
Of 726 patients with FAP, 104 (14 %; 49 female) were diagnosed with gastric adenomas at a median age of 47 years (range 19 - 80). The median size of gastric adenomas was 6 mm (range 1.5 - 50); 64 (62 %) patients had adenomas located distally to the incisura. Five patients (5 %) had gastric adenomas demonstrating high-grade dysplasia (HGD) on initial diagnosis, distributed equally within the stomach. The risk of HGD was associated with adenoma size (
CONCLUSIONS
We observed gastric adenomas in 14 % of patients with FAP. Of these, 5 % contained HGD; risk of HGD correlated with adenoma size. Endoscopic resection was feasible, with few complications and low recurrence rates, but did not completely eliminate the cancer risk.
Identifiants
pubmed: 32942317
doi: 10.1055/a-1265-2716
pmc: PMC8315898
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
795-801Commentaires et corrections
Type : CommentIn
Informations de copyright
The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Déclaration de conflit d'intérêts
Prof. Dekker has received a research grant and equipment loans from FujiFilm. She has also received honoraria for consultancy work for FujiFilm, Olympus, Tillots, GI Supply, and CPP-FAP, and speaker fees from Olympus, Roche, and GI supply. All other authors declare that they have no conflicts of interest.
Références
Gut. 2002 Oct;51(4):485-9
pubmed: 12235068
Lancet. 1988 May 21;1(8595):1149-51
pubmed: 2896968
J R Soc Med. 1991 Aug;84(8):476-8
pubmed: 1653358
Fam Cancer. 2017 Jul;16(3):371-376
pubmed: 28185118
Gut Liver. 2011 Mar;5(1):46-51
pubmed: 21461071
Dis Colon Rectum. 1990 Aug;33(8):639-42
pubmed: 2165452
Dis Colon Rectum. 1992 Dec;35(12):1170-3
pubmed: 1335405
Clin Gastroenterol Hepatol. 2008 Feb;6(2):180-5
pubmed: 18237868
Dis Colon Rectum. 1993 Nov;36(11):1059-62
pubmed: 8223060
Ann Surg. 1993 Feb;217(2):101-8
pubmed: 8382467
Hum Mutat. 1994;3(2):121-5
pubmed: 8199592
Science. 1991 Aug 9;253(5020):661-5
pubmed: 1651562
Jpn J Clin Oncol. 2016 Apr;46(4):310-5
pubmed: 26819281
Tohoku J Exp Med. 2013;229(2):143-6
pubmed: 23343691
J Med Genet. 2018 Jan;55(1):11-14
pubmed: 28490611
Gut. 1987 Mar;28(3):306-14
pubmed: 3032754
Hered Cancer Clin Pract. 2014 Feb 24;12(1):4
pubmed: 24565534
Fam Cancer. 2017 Jul;16(3):363-369
pubmed: 28271232
Gastrointest Endosc. 2019 May;89(5):961-968
pubmed: 30597145
Am J Surg Pathol. 2014 Mar;38(3):389-93
pubmed: 24525509
Cancer. 1988 Feb 1;61(3):605-11
pubmed: 3338026