Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis

Background and study aims Gastric cancer (GC) is increasingly reported and a leading cause of death in patients with familial adenomatous polyposis (FAP). Identifying features in patients with FAP who harbor sessile gastric polyps, likely precursors to GC, may lead to alterations in endoscopic surve...

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Main Authors: Gautam N. Mankaney, Michael Cruise, Shashank Sarvepalli, Amit Bhatt, David Liska, Carol A. Burke
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2022-08-01
Series:Endoscopy International Open
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-1839-5185
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author Gautam N. Mankaney
Michael Cruise
Shashank Sarvepalli
Amit Bhatt
David Liska
Carol A. Burke
author_facet Gautam N. Mankaney
Michael Cruise
Shashank Sarvepalli
Amit Bhatt
David Liska
Carol A. Burke
author_sort Gautam N. Mankaney
collection DOAJ
description Background and study aims Gastric cancer (GC) is increasingly reported and a leading cause of death in patients with familial adenomatous polyposis (FAP). Identifying features in patients with FAP who harbor sessile gastric polyps, likely precursors to GC, may lead to alterations in endoscopic surveillance in those patients and allow endoscopic intervention to decrease the risk of GC. The aim of this study was to identify demographic and clinical factors in patients with FAP who harbor sessile gastric polyps. Patients and methods We retrospectively compared demographic, clinical, and endoscopic features in consecutive adult patients with FAP who presented for a surveillance endoscopy at a tertiary-care center with a FAP registry who harbor sessile gastric polyps to those without them. Sessile gastric polyps included pyloric gland adenomas, gastric adenomas, hyperplastic polyps, and fundic gland polyps with high-grade dysplasia. We also display the location of germline APC pathogenic variants in patients with and without sessile gastric polyps. Results Eighty patients with FAP were included. Their average age was 48 years and 70 % were male. Nineteen (24 %) had sessile gastric polyps. They were older (P < 0.03), more likely to have a family history of GC (P < 0.05), white mucosal patches in the proximal stomach (P < 0.001), and antral polyps (P < 0.026) compared to patients without a gastric neoplasm. No difference in Spigelman stage, extra-intestinal manifestations, or surgical history was note. 89 % of patients with a gastric neoplasm had an APC pathogenic variant 5’ to codon 1309. Conclusions Specific demographic, endoscopic, and genotypic features are associated with patients with FAP who harbor sessile gastric polyps. We recommend heightened awareness of these factors when performing endoscopic surveillance of the stomach with resection of gastric neoplasia when identified.
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spelling doaj.art-38564a6568a840efaabc04068f3d1c122022-12-22T01:35:54ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362022-08-011008E1080E108710.1055/a-1839-5185Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposisGautam N. Mankaney0Michael Cruise1Shashank Sarvepalli2Amit Bhatt3David Liska4Carol A. Burke5Virginia Mason Franciscan Health – Digestive Disease Institute, Seattle, Washington, United StatesDepartment of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, United StatesBaylor College of Medicine – Digestive Diseases, Houston, Texas, United States Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, United StatesDepartment of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio, United States Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, United StatesBackground and study aims Gastric cancer (GC) is increasingly reported and a leading cause of death in patients with familial adenomatous polyposis (FAP). Identifying features in patients with FAP who harbor sessile gastric polyps, likely precursors to GC, may lead to alterations in endoscopic surveillance in those patients and allow endoscopic intervention to decrease the risk of GC. The aim of this study was to identify demographic and clinical factors in patients with FAP who harbor sessile gastric polyps. Patients and methods We retrospectively compared demographic, clinical, and endoscopic features in consecutive adult patients with FAP who presented for a surveillance endoscopy at a tertiary-care center with a FAP registry who harbor sessile gastric polyps to those without them. Sessile gastric polyps included pyloric gland adenomas, gastric adenomas, hyperplastic polyps, and fundic gland polyps with high-grade dysplasia. We also display the location of germline APC pathogenic variants in patients with and without sessile gastric polyps. Results Eighty patients with FAP were included. Their average age was 48 years and 70 % were male. Nineteen (24 %) had sessile gastric polyps. They were older (P < 0.03), more likely to have a family history of GC (P < 0.05), white mucosal patches in the proximal stomach (P < 0.001), and antral polyps (P < 0.026) compared to patients without a gastric neoplasm. No difference in Spigelman stage, extra-intestinal manifestations, or surgical history was note. 89 % of patients with a gastric neoplasm had an APC pathogenic variant 5’ to codon 1309. Conclusions Specific demographic, endoscopic, and genotypic features are associated with patients with FAP who harbor sessile gastric polyps. We recommend heightened awareness of these factors when performing endoscopic surveillance of the stomach with resection of gastric neoplasia when identified.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1839-5185
spellingShingle Gautam N. Mankaney
Michael Cruise
Shashank Sarvepalli
Amit Bhatt
David Liska
Carol A. Burke
Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
Endoscopy International Open
title Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
title_full Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
title_fullStr Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
title_full_unstemmed Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
title_short Identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
title_sort identifying factors associated with detection of sessile gastric polyps in patients with familial adenomatous polyposis
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-1839-5185
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