Macroscopically visible flat dysplasia in the fundus of 3 patients with familial adenomatous polyposis

Calavas, Laura; Rivory, Jérôme; Hervieu, Valérie; Saurin, Jean‐Christophe; Pioche, Mathieu

doi:10.1016/j.gie.2016.03.1499

Cited by 13 publications

(6 citation statements)

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“…13 The images the authors provide for the proximal W and T categories depict proximal white mucosal patches (sharply demarcated areas of pale areas of gastric mucosa). We and others have found that stomachs containing these mucosal findings contain high-risk gastric pathologic changes both within and outside of the patch 16,17 and serve as markers signaling endoscopists to closely examine the stomach.…”

mentioning

confidence: 87%

Finding the needle in a haystack: approach to detection of high-risk gastric lesions in familial adenomatous polyposis

Mankaney

Cruise

Burke

2021

Gastrointestinal Endoscopy

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confidence: 87%

Finding the needle in a haystack: approach to detection of high-risk gastric lesions in familial adenomatous polyposis

Mankaney

Cruise

Burke

2021

Gastrointestinal Endoscopy

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“…While the precursor lesion to GC in FAP has not been confirmed, observational data suggests GC most likely arises from a gastric neoplasm such as a pyloric gland adenoma, gastric adenoma, or fundic gland polyps with high-grade dysplasia. These neoplastic lesions are more prevalent in patients with FAP related GC 1 8 9 10 11 . Recent data suggest mucosal features on endoscopy can differentiate neoplastic gastric polyps from fundic gland polyps with low-grade or no dysplasia in patients with FAP with a sensitivity and specificity of 79 % and 80 %, respectively 12 .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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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“… 70 Another high-risk gastric lesion in FAP are gastric white patches, which may reflect underlying adenomatous mucosa and likely portend a higher gastric cancer risk. 71–73 …”

Section: Introductionmentioning

confidence: 99%

“…70 Another high-risk gastric lesion in FAP are gastric white patches, which may reflect underlying adenomatous mucosa and likely portend a higher gastric cancer risk. [71][72][73] Surveillance Current upper GI surveillance guidelines from both the American College of Gastroenterology (ACG) and the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG), published in 2015 and 2020, respectively, strongly recommend earlier initiation of upper GI surveillance at age 25-30 with interval every 0.5-4 years according to Spigelman classification of duodenal polyposis. 41,42 Random sampling of gastric fundic gland polyps is also recommended, although fundic gland polyps with low-grade dysplasia are common in FAP and do not warrant more aggressive management in the absence of other concerning findings.…”

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confidence: 99%

Endoscopic Surveillance in Patients with the Highest Risk of Gastric Cancer: Challenges and Solutions

Long¹,

Ebrahimzadeh²,

Stanich³

et al. 2022

CMAR

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Gastric cancer is one of the most significant causes of cancer-related morbidity and mortality worldwide. Recognized modifiable risk factors include Helicobacter pylori infection, geographic location, select dietary factors, tobacco use and alcohol consumption. In addition, multiple hereditary cancer predisposition syndromes are associated with significantly elevated gastric cancer risk. Endoscopic surveillance in hereditary gastric cancer predisposition syndromes has the potential to identify gastric cancer at earlier and more treatable stages, as well as to prevent development of gastric cancer through identification of precancerous lesions. However, much uncertainty remains regarding use of endoscopic surveillance in hereditary gastric cancer predisposition syndromes, including whether or not it should be routinely performed, the surveillance interval and age of initiation, cost-effectiveness, and whether surveillance ultimately improves survival from gastric cancer for these high-risk individuals. In this review, we outline the hereditary gastric cancer predisposition syndromes associated with the highest gastric cancer risks. Additionally, we cover current evidence and guidelines addressing hereditary gastric cancer risk and surveillance in these syndromes, along with current challenges and limitations that emphasize a need for continued research in this field.

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Macroscopically visible flat dysplasia in the fundus of 3 patients with familial adenomatous polyposis

Cited by 13 publications

References 0 publications

Finding the needle in a haystack: approach to detection of high-risk gastric lesions in familial adenomatous polyposis

Finding the needle in a haystack: approach to detection of high-risk gastric lesions in familial adenomatous polyposis

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

Endoscopic Surveillance in Patients with the Highest Risk of Gastric Cancer: Challenges and Solutions

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