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, 13 (4), 409-414

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

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

Kentaro Yamashita et al. Gut Liver.

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.

Keywords: Fundic gland polyps; Gastric xanthomas; Hyperplastic polyps; Stomach neoplasms.

Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A) Endoscopic image of a fundic gland polyp. (B) Endoscopic image of a gastric hyperplastic polyp. (C) Endoscopic image of gastric xanthomas (arrows).
Fig. 2
Fig. 2
(A) Pathological findings of an xanthoma (XT; H&E stain, ×100). (B) Immunohistochemistry for CD68 (KP1), a marker of macrophages, in an XT (×100).

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