Gut Liver.  2019 Jul;13(4):409-414. 10.5009/gnl17136.

Gastric Xanthomas and Fundic Gland Polyps as Endoscopic Risk Indicators of Gastric Cancer

• Yamashita
• Suzuki R
• Kubo T
• Onodera K
• Iida T
• Saito M
• Arimura Y
• Endo T
• Nojima M
• Nakase H

• KMID: 2458524
• DOI: http://doi.org/10.5009/gnl17136

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.

Keyword

Fundic gland polyps; Gastric xanthomas; Hyperplastic polyps; Stomach neoplasms

MeSH Terms

Gastroscopy
Humans
Polyps*
Prevalence
Stomach Neoplasms*
Xanthomatosis*