Gut Liver.  2011 Mar;5(1):46-51.

Prevalence of Gastric and Duodenal Polyps and Risk Factors for Duodenal Neoplasm in Korean Patients with Familial Adenomatous Polyposis

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. jkryu@snu.ac.kr
  • 2Department of General Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 4Department of General Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 5Colon Cancer Center, National Cancer Center, Goyang, Korea.

Abstract

BACKGROUND/AIMS
The prevalence of gastric polyps, duodenal adenoma and duodenal cancer has been reported as being high among familial adenomatous polyposis (FAP) patients, but there have been no reports of this association in Korea. This study evaluated the prevalence of gastric and duodenal polyps and risk factors for duodenal neoplasm in FAP patients in Korea.
METHODS
We reviewed both initial and follow-up endoscopic results from FAP patients. We also investigated the treatment modality of duodenal adenomas and analyzed the risk factors of duodenal neoplasms by logistic regression analysis.
RESULTS
A total of 148 patients with FAP underwent esophagogastroduodenoscopy (EGD), and the fi ndings were as follows: gastric polyp 39.9% (fundic gland polyp 25.7% and gastric adenoma 14.2%), duodenal adenoma 15.5%, gastric cancer 2.7%, and duodenal cancer 0.7%. There were two cases of gastric cancer that developed from benign gastric polyps. There were progressions of duodenal adenomatosis during follow-up, and some degree of relapse occurred after endoscopic resection. Patients with gastric polyps showed a correlation with the occurrence of duodenal neoplasm (odds ratio, 2.814; p=0.024).
CONCLUSIONS
In Korean FAP patients, gastric cancer was detected more frequently, but fundic gland polyps, duodenal adenoma and duodenal cancer were detected less frequently than in Western patients. FAP patients with gastric polyps should undergo regular EGD, particularly for the early detection of duodenal neoplasia.

Keyword

Familial adenomatous polyposis; Duodenal cancer; Polyps; Adenomas; Gastric cancer

MeSH Terms

Adenoma
Adenomatous Polyposis Coli
Duodenal Neoplasms
Endoscopy, Digestive System
Follow-Up Studies
Humans
Korea
Logistic Models
Polyps
Prevalence
Recurrence
Risk Factors
Stomach Neoplasms
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