Fundic gland polyps is more common in patients with relative healthy gastric mucosa

Abstract

Fundic gland polyps (FGPs) have become the most common gastric polyp in recent years. Long‐term use of proton pump inhibitor (PPI) and negative correlation with Helicobacter pylori had been reported in patients with sporadic FGPs. However, the incidence of sporadic FGPs unrelated to PPI has also increased in recent years. This study is to investigate factors, including the PPI use, Helicobacter pylori, and others, which may affect the development of FGPs. The clinical features of all consecutive FGP patients who were diagnosed by histological confirmation from January 2010 to December 2015 were retrospectively analyzed. In all, 40 142 patients received esophagogastroduodenoscopy during the study period, and 344 patients (0.9%) were diagnosed as having FGPs. The medical data, including indication for esophagogastroduodenoscopy, systemic diseases, PPI uses, H. pylori status, and endoscopic findings, were retrieved. Three age‐ and sex‐matched patients who received esophagogastroduodenoscopy in the same period were selected as controls for each FGP patient. In total 1030 patients were included in this study to compare the clinical features of FGPs. The prevalence of FGPs significantly increased from 0.6% in 2010 to 1.3% in 2015. The mean age of FGP patients was (57.07 ± 14.79) years, and 75.0% were female. Univariate analysis and multivariate analysis found independent positive factors for FGPs: health checkup with esophagogastroduodenoscopy (OR 2.3) and use of PPI for more than six months (OR 1.988). Independent negative factors found were: esophagogastroduodenoscopy that revealed gastric ulcer (OR 0.3) or duodenal ulcer (OR 0.4), positivity for H. pylori (OR 0.2), and liver cirrhosis (OR 0.2). The prevalence of FGPs had significantly increased in recent years and were found in patients with low levels of caustic factors in the gastric mucosa, such as long‐term use of PPI, absence of H. pylori, and absence of gastropathy that induce peptic ulcers. The disease as liver cirrhosis that may induce gastropathy is a negative independent factor for FGPs development.