Risk of colorectal polyps in patients with sporadic gastric polyps: A case-control study

Abstract

AIM:To assess the risk of colonic polyps, adenomas and advanced neoplastic lesions (ANL) in patients with sporadic gastric polyps, especially those with fundic gland polyps (FGP). METHODS:Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed. A case-control study was carried out, calling patients with gastric polyps as "cases" and patients without gastric polyps as "controls". The risk of colonic polyps, adenomas and ANL (villous component ≥ 25%, size ≥ 10 mm, or high grade dysplasia) was assessed [odds ratio (OR) and its corresponding 95%CI]. RESULTS:Two hundred and forty seven patients were analyzed: 78 with gastric polyps (cases) and 169 without gastric polyps (controls). Among the cases, the majority of gastric polyps were FGP (80%, CI: 69-88) and hyperplastic (20%, CI: 12-31); 25% had colonic polyps (25% hyperplastic and 68% adenomas, from which 45% were ANL). Among the controls, 20% had colonic polyps (31% hyperplastic and 63% adenomas, from which 41% were ANL). The patients with sporadic FGP had an OR of 1.56 (CI: 0.80-3.04) for colonic polyps, an OR of 1.78 (CI: 0.82-3.84) for colonic adenomas, and an OR of 0.80 (CI: 0.21-2.98) for ANL. Similar results were found in patients with gastric polyps in general. CONCLUSION:The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.© 2013 Baishideng. All rights reserved.Key words: Colorectal polyps; Advanced neoplastic lesions; Gastric polyps; Fundic gland polyps gastric polyps; Case-control study Core tip: The risk of colonic adenomas in patients who have sporadic gastric polyps, especially those of fundic gland polyps (FGP), is still to be definitely determined. The purpose of our study was to assess the risk of colonic polyps, adenomas and advanced neoplastic lesions in patients who have sporadic gastric polyps, especially of FGP, due to the fact that these are the most common gastric polyps in our population.

Clinical Significance of Colonoscopy in Patients with Upper Gastrointestinal Polyps and Neoplasms: A Meta-Analysis

“…Specially, one study was excluded because it focuses on neoplasms on papilla of vater [44] . Finally, we included 3 prospective [17] , [24] , [29] and 21 retrospective [15] , [16] , [18] – [23] , [25] – [28] , [30] – [38] case-control studies satisfied the primary selection criteria for this meta-analysis ( Figure 1 ).…”

“…Four studies [15] , [16] , [19] , [20] with 1972 cases and 24612 controls compared the risk of colorectal polyps in patients with gastric polyps than those without gastric polyps. The overall prevalence of colorectal polyps was 37.3% (736 of 1972) in cases and 33.9% (8348 of 24612) in controls, yielding a pooled OR of 1.15 (95%CI, 1.04–1.26) ( Figure 2 ).…”

“…Some authors [15] – [38] have studied the relationship between the presence of polyps, adenomas and cancers of upper GI tract and risk of colorectal polyps and neoplasms; however, the results are controversial, which may be due to study sample size, populations, design, clinical features, and so on. No meta-analysis of this issue existed so far.…”

Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in China

“…Although one study has shown that the association between gastric polyps and colorectal polyps remained positive after gender stratification 10, another study only found a positive association in women 11. Besides, very few studies addressed the outcome of advanced colorectal adenomas, despite only one case-control study with small sample size 12, showing no significant association between gastric polyps and the advanced colorectal adenomas.…”

Inflammatory fibroid polyp in the antrum co-occurring with adenomatous polyp in the ascending colon

“…Because there is no real risk of transforming into stomach cancer in such cases, follow-up endoscopy is not recommended [16]. Studies also did not find increased risk of colorectal adenomas in patients with sporadic FGPs [16, 17]. In patients with FAP, the incidence rate of FGPs is significantly increased, and they are even treated as a symptom of FAP.…”