Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

Choudhry, Umesh; Hw, Boyce; Coppola, Dominico

doi:10.1093/ajcp/110.5.615

Cited by 178 publications

(121 citation statements)

References 5 publications

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“…In contrast to reports by Carmack et al (10) and Stolte et al (30), in which fundic gland polyps were reported as the most common gastric polyps, with a relative frequency of 77% and 47%, respectively, in our study, fundic gland polyps accounted for less than 6.1% of all polyps. Fundic gland polyps have almost no malignant potential when they are associated with the use of PPIs (11,31,32) or when they occur sporadically (33). Similarly, we found neither dysplasia nor malignancy in the fundic gland polyps in our study.…”

Section: Discussionsupporting

confidence: 44%

Evaluation of gastric polyps detected by endoscopy: A single-center study of a four-year experience in Turkey

Atalay

Solakoğlu²,

Sarı³

et al. 2020

Turk J Gastroenterol

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Background/Aims: The aim of this study was to evaluate the gastric polyps detected by endoscopy in our institution with respect to their frequency, size, anatomic location, presence of dysplasia, and histopathologic features. Materials and Methods: Records of a total of 14,240 patients who underwent endoscopy between January 2008 and January 2012 were reviewed retrospectively. Of the 14,240 patients, 174 determined to have at least 1 histopathologically proven polyp were included in the study. Results: Three hundred eleven gastric polyps were found in 174/14,240 (1.2%) patients (1.79 polyps per patient). Gastric polyps were found most commonly in the antrum (41.5%). Of all gastric polyps, 189 (60.8%) were less than 1 cm. Histopathologically, the most common polyp type was hyperplastic (n: 261, 83.9%), followed by adenomatous (n: 23, 7.4%). Eight (34.8%) of the adenomatous polyps showed dysplasia, and in 4 (17.4%) of these cases, the dysplasia was high-grade. Nineteen (6.1%) of all gastric polyps were identified to be fundic gland polyps. Conclusion: According to this study from Turkey, the majority of polyps detected by endoscopy was solitary, smaller than 1 cm, and found in the antrum; furthermore, the most common type was a hyperplastic polyp.

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Section: Discussionsupporting

confidence: 44%

Evaluation of gastric polyps detected by endoscopy: A single-center study of a four-year experience in Turkey

Atalay

Solakoğlu²,

Sarı³

et al. 2020

Turk J Gastroenterol

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“…Chronic ECL cell stimulation also results as reflected by increased levels of chromogranin A, an endocrine cell product [22] . In recent years, gastric fundic gland polyps have become increasingly detected in patients on long-term proton pump inhibitor therapy [23][24][25][26] . These fundic gland polyps are often multiple in this setting and localized in the gastric body and fundus.…”

Section: Proton Pump Inhibitor-associated Gastric Polypsmentioning

confidence: 99%

Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis

Freeman¹

2008

WJG

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“…PPIs are also used adjuvantly in the eradication of H. pylori 3) . With widespread use of PPIs came reports of gastric mucosal changes including fundic gland hyperplasia 4) , cystic dilation of fundic glands (oxyntic dilatation) 5) 6) , emergence and enlargement of socalled fundic gland polyps (FGPs) [7][8][9][10][11] , and morphologic changes in parietal cells 12) . The parietal cell protrusions (PCPs) found in patients treated with omeprazole are thought to be an especially characteristic change [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Histopathologic and Immunohistochemical Characterization of Human Gastric Oxyntic Mucosa with Parietal Cell Protrusions and Investigation into the Association Between Such Mucosal Changes of the Stomach and Use of Proton Pump Inhibitors

Naruki

Fukushima

Ohnuma

et al. 2015

J St. Marianna Univ

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With widespread use of proton pump inhibitors (PPIs) has come characteristic gastric mucosal changes such as parietal cell protrusions (PCPs) and so-called fundic gland polyps (FGPs). Nevertheless, whether these lesions are actually PPI-related gastric mucosal lesions has not been fully clarified. The present study focused on this issue. We firstly examined the purported relation between the emergence of PCPs and PPI use. We also investigated the relation between PPI use and the emergence of cystically dilated glands (CDGs) that can give rise to elevated mucosal lesions such as FGPs. In addition, we performed histopathologic and immunohistochemical analyses to clarify the characteristics of PCPs and PCP-affected gastric oxyntic mucosa. A significant relation between the emergence of PCPs and PPI use was confirmed. In contrast, no significant relation was found between the emergence of CDGs and PPI use. Histologic and immunohistochemical analyses showed PCPs to be hyperplastic lesions. In the PCP-affected oxyntic mucosa, the isthmus-and-neck region of the fundic glands was elongated and the base region was shortened in relation to the total mucosal thickness. These changes were accompanied by an increase in the number of parietal cells and a decrease in the number of chief cells. Immunohistochemical analysis suggested impairment of both parietal cell differentiation and mucous neck-to-chief cell differentiation．Furthermore, our study reinforced the notion that elevated hydrostatic pressure and cytoplasmic edema due to movement of water from interstitial space toward the lumen of oxyntic glands via parietal cells give rise to the formation of PCPs, oxyntic dilatation, and CDGs. The detailed mechanism of PCP formation and its clinical implications are expected to be clarified in future studies.

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Proton Pump Inhibitor-Associated Gastric Polyps: A Retrospective Analysis of Their Frequency, and Endoscopic, Histologic, and Ultrastructural Characteristics

Cited by 178 publications

References 5 publications

Evaluation of gastric polyps detected by endoscopy: A single-center study of a four-year experience in Turkey

Evaluation of gastric polyps detected by endoscopy: A single-center study of a four-year experience in Turkey

Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis

Histopathologic and Immunohistochemical Characterization of Human Gastric Oxyntic Mucosa with Parietal Cell Protrusions and Investigation into the Association Between Such Mucosal Changes of the Stomach and Use of Proton Pump Inhibitors

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