Gut and Liver Gastric Xanthomas and Fundic Gland Polyps as Endoscopic Risk Indicators of Gastric Cancer
Author Information
Kentaro Yamashita1, Ryo Suzuki1, Toshiyuki Kubo1, Kei Onodera1, Tomoya Iida1, Mayuko Saito1, Yoshiaki Arimura2, Takao Endo3, Masanori Nojima4, and Hiroshi Nakase1
1Department of Gastroenterology and Hepatology, Sapporo Medical University, Sapporo, 2Department of Gastroenterology, Otaru City General Hospital, Otaru, 3Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, and 4Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

Kentaro Yamashita
Department of Gastroenterology and Hepatology, Sapporo Medical University, S1W16 Chuo-ku, Sapporo 060-8543, Japan
Tel: +81-11-6112111, Fax: +81-11-6112282, E-mail: ykentaro@sapmed.ac.jp
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: Fundic gland polyps (FGPs), hyperplastic polyps (HPs) and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. Methods: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. Results: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. Conclusions: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Keywords: Fundic gland polyps; Gastric xanthomas; Hyperplastic polyps; Stomach neoplasms
Abstract
Background/Aims: Fundic gland polyps (FGPs), hyperplastic polyps (HPs) and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. Methods: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. Results: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. Conclusions: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Keywords: Fundic gland polyps; Gastric xanthomas; Hyperplastic polyps; Stomach neoplasms
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