Types Of Gastric Polyps Research Articles

The Sensitivity of Immunohistochemical Expression of p53 as an Indicator of the Malignant Potential of Gastric Hyperplastic Polyps: A Retrospective Study

Background: Hyperplastic polyps account for 30–93% of gastric polyps. Recently, there have been studies about the development of dysplasia in this type of polyp. Every cell in the body contains the p53 gene, which has anti-cancer properties. Objective: The sensitivity of immunohistochemical expression of p53 is evaluated among gastric hyperplastic polyps with and without dysplasia and gastric adenomatous polyps to know its usefulness as a diagnostic marker. Methods: A retrospective cross-sectional study was done on fifty formalin-fixed paraffin-embedded blocks of gastric polyps (44 hyperplastic polyps without dysplasia, 3 hyperplastic polyps with dysplasia, and 3 adenomas). Cases were collected from the archives of the pathology department from June 2019 to July 2023. Additional sections of the block were immunostained with P53 protein. Results: Fifty paraffin blocks from patients with gastric polyps (17 males, 33 females) were included in the study. 44 of the cases are classified as hyperplastic polyps, 3 as hyperplastic polyps with dysplasia, and 3 as adenomatous polyps. Most gastric hyperplastic polyps showed staining in different scores. All gastric hyperplastic polyps with dysplasia showed nuclear staining, whereas two out of three gastric adenomatous polyps showed no staining. Conclusion: There was no significant association between p53 protein expression and the type of gastric polyps, the presence of intestinal metaplasia, or H. pylori. However, it has a significant correlation with the size of the polyps.

Analysis of the Clinical Features of Patients with Gastric Polyps and the Digestive Endoscopic Manifestations of Different Types of Gastric Polyps

Analysis of the Clinical Features of Patients with Gastric Polyps and the Digestive Endoscopic Manifestations of Different Types of Gastric Polyps

Association Between Low Muscle Mass and Gastric Hyperplastic and Inflammatory Polyps in Chinese Asymptomatic Adult Males.

BackgroundGastric polyp is an abnormally proliferative or neoplastic growth of the gastric mucosa, with a degree of tendency to transform into gastric cancer. Lack of physical activity that is significantly related to low muscle mass (LMM) and muscle strength has been identified to be associated with gastric polyps. In this study, we examine the association of LMM and different histological types of gastric polyps among Chinese asymptomatic adult males.MethodsIn total, 1,742 male adults undergoing bioelectrical impedance analysis and upper gastrointestinal endoscopies were included. Univariate and multivariate logistic regression models were used to analyze the effect of LMM on the risk of gastric polyps and different histological types.ResultsBy univariate and multivariate analyses, LMM (OR: 1.689, 95%CI: 1.046–2.726, p = 0.032) kept independent effect on risk of gastric polyps. When ratio of appendicular skeletal muscle mass to body mass index(ASM/BMI) was brought into the analyses, it was identified to be negatively correlated with occurrence of gastric polyps (OR: 0.744, 95%CI: 0.566–0.977, p = 0.033). For different pathological types, LMM showed different effect on occurrence of gastric polyps. LMM was an independent indicator for hyperplastic and inflammatory polyps (OR: 2.378, 95%CI: 1.288–4.389, p = 0.006), rather than fundic gland polyps (OR: 1.013, 95%CI: 0.473–2.173, p = 0.973).ConclusionIn general, LMM was an independent indicator for hyperplastic and inflammatory polyps occurrence in Chinese asymptomatic adult males.

Gastric polyps: a 10-year analysis of 18,496 upper endoscopies

Background/aimsGastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 1–3% of esophagogastroduodenoscopies (EGD). Most GPs are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors.Materials and methodsA total of 18,496 consecutive patients undergoing EGD over a 10-year period (between 2007 and 2018) in a tertiary hospital were retrospectively reviewed. Eighty-six patients diagnosed with gastric polyps were analysed. Demographics, medical history of the patients, and indication for gastroscopy were collected. Morphological, histological characteristics of polyps, and therapeutic management data were also collected.ResultsGPs were found in 86 out of 18,496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. There were 64 female (74.4%) and 22 male patients (25.6%) with a sex ratio (M/F) of 0.34. The average age was 58.1 years. One hundred and forty one polyps were included, and histopathology was obtained on 127 GPs. The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. The polyp was unique in 75.6% of cases. According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%), followed by sporadic fundic gland polyps observed in 23 patients (18.1%), 7 (5.5%) were adenomas and 4 (3.1%) were neuroendocrine tumors type 1. The following factors were associated with hyperplastic polyps: anemia (p = 0.022), single polyp (p = 0.025) and size ≥ 5 mm (p = 0.048). Comparing hyperplastic polyps’ biopsies to resected polyps, no difference was found in the evolutionary profile of the 2 groups. A size less than 10 mm (p = 0.013) was associated with fundic gland polyps. Sixty polyps (47.2%) were treated by cold forceps, 19 (15%) treated by a mucosal resection and 15 (11.8%) with diathermic snare. Five procedural bleeding incidents were observed (3.9%). Only the use of anticoagulant treatment was associated with a high bleeding risk (p = 0.005). The comparative histological study between specimens of biopsied GPs and endoscopic polypectomy led to an overall agreement of 95.3%.ConclusionIn our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common in our country. The high frequency of Helicobacter pylori infection in our patients and in our area may explain the high frequency of HP.

The clinicopathological characteristics of gastric polyps and the relationship between fundic gland polyps, Helicobacter pylori infection, and proton pump inhibitors

To explore the clinical characteristics of different types of gastric polyps and the relationship between fundic gland polyps, Helicobacter pylori (HP) infection, and proton pump inhibitor (PPI) use. The clinical data of 186 patients diagnosed with gastric polyps under endoscopy were selected for retrospective analysis, and the clinical data, gastroscopy, polyp histopathology, HP infection, and PPI usage of all subjects were analyzed. Among the 186 patients with gastric polyps, there were significantly more women (131 cases) than men (55 cases), with a ratio of 2.38:1. PPIs were used in 78% of cases for more than 5 years. The pathological types of patients with gastric polyps in this study were fundic gland polyps, hyperplastic polyps, inflammatory fibrous polyps, and adenomatous polyps. Fundic gland polyps were mainly located in the fundus and gastric body, while hyperplastic polyps were mostly located in the gastric body (P<0.05). The positive rate of HP infection in patients with fundic gland polyps was significantly lower than that in patients with other types of polyps (P<0.05). In patients with long-term use of PPIs, the incidence of fundic gland polyps increased significantly (P<0.05). There were significant differences among the different types of gastric polyps in terms of polyp position, shape, and size. The positive rate of HP infection in patients with fundic gland polyps was low. Long-term use of PPIs (>5 years) increased the incidence of fundic gland polyps to some extent. The mechanisms underlying the relationship between gastric polyps, HP infection, and the use of PPIs remain to be further studied.

Progress in clinical diagnosis and treatment for gastric polyps.

Gastric polyps are common precancerous diseases. With the intensive study on the characteristics of different types of gastric polyps in recent years, only 1.7% of the gastric polyps were found to have dysplasia and cancer, and most of the dysplasia and cancer were found in polyps larger than 1 cm. Traditional idea suggests that polyps should be removed immediately, but routine removal of all polyps results in an increased financial burden on patients. At present, there are controversies about whether endoscopic treatment is necessary for different pathological types and small gastric polyps.

Gastric Polyposis Syndromes

Abstract Most gastric polyps are fundic gland polyps and hyperplastic polyps. Adenomas, inflammatory fibroid polyps, and neuroendocrine tumors are other types of gastric polyps that occur less frequently. Rarely, a gastric polyp may be associated with a syndrome, including hereditary cancer syndromes. Some of these syndromes are also associated with an increased risk of gastric cancer. We present a case of a 50-year-old woman with known Cowden syndrome who presents with multiple gastric hamartomatous polyps. We then review the clinical, endoscopic, and pathologic features of various syndromes that are associated with gastric polyps. Fundic gland polyp–predominant syndromes include familial adenomatous polyposis, gastric adenocarcinoma and proximal polyposis of the stomach, and MUTYH-associated polyposis, all of which are hereditary cancer syndromes. Gastric hamartomatous polyps are found in patients with juvenile polyposis syndrome, Peutz-Jeghers syndrome, PTEN hamartoma tumor syndrome including Cowden syndrome, and Cronkhite-Canada syndrome. Syndromic gastric polyps may be biopsied in patients with a previously established diagnosis of the underlying syndrome, such as surveillance endoscopies in familial adenomatous polyposis. On other occasions, the pathologic assessment of gastric polyps may prompt or contribute to a diagnostic workup of an underlying syndrome in conjunction with other clinical and endoscopic findings.

Gastric polyps: Retrospective analysis of 41,253 upper endoscopies

Abstract Introduction Gastric polyps are usually asymptomatic lesions incidentally discovered during endoscopy. Objective To study the frequency of different types of gastric polyps in our population and their possible association with other factors. Patients and methods Retrospective study of gastroscopies performed in a tertiary hospital over a ten-year period. Demographics, medical history, indication for gastroscopy and morphological and histological characteristics of polyps were collected. Results Gastric polyps were found in 827 out of 41253 (2%) reviewed gastroscopies, corresponding to 709 patients. Mean age was 65.6 years, and 62% were female. 53.9% of patients had multiple polyps. The most common location was the fundus and 83.3% were smaller than 1 cm. Histopathology was obtained in 607 patients: hyperplastic polyps were the most common (42.8%), followed by fundic gland polyps (37.7%). Factors independently associated with hyperplastic polyps were age and single polyp, size ≥6 mm and location other than fundus. In contrast, fundic gland polyps were associated with reflux and multiple polyps, size Conclusions Fundic gland and hyperplastic polyps are the most common in our population and have characteristic features that can guide histological diagnosis. With single polyps it is advisable to take biopsies to rule out adenoma.

Pólipos gástricos: análisis retrospectivo de 41.253 endoscopias digestivas altas

IntroductionGastric polyps are usually asymptomatic lesions incidentally discovered during endoscopy. ObjectiveTo study the frequency of different types of gastric polyps in our population and their possible association with other factors. Patients and methodsRetrospective study of gastroscopies performed in a tertiary hospital over a ten-year period. Demographics, medical history, indication for gastroscopy and morphological and histological characteristics of polyps were collected. ResultsGastric polyps were found in 827 out of 41253 (2%) reviewed gastroscopies, corresponding to 709 patients. Mean age was 65.6 years, and 62% were female. 53.9% of patients had multiple polyps. The most common location was the fundus and 83.3% were smaller than 1cm. Histopathology was obtained in 607 patients: hyperplastic polyps were the most common (42.8%), followed by fundic gland polyps (37.7%). Factors independently associated with hyperplastic polyps were age and single polyp, size ≥6mm and location other than fundus. In contrast, fundic gland polyps were associated with reflux and multiple polyps, size <6mm and located in fundus. Adenomas were independently associated with single polyp. ConclusionsFundic gland and hyperplastic polyps are the most common in our population and have characteristic features that can guide histological diagnosis. With single polyps it is advisable to take biopsies to rule out adenoma.

Comparison of clinicopathological features between gastric polyps and colorectal polyps

Objective To compare of clinical and pathological features between gastric polyps and colorectal polyps. Methods The clinical characteristics and pathological features of 2 125 patients with gastric polyps and 4 924 patients with colorectal polyps admitted in Wenzhou People's Hospital from 2004 to 2013 were compared. The detection rates, the indication of endoscopy, distribution, number, size and pathological type of gastric polyps and colorectal polyps were analyzed. Results The detection rate of gastric polyps was 3.1%(2 125/69 575)and that of colorectal polyps was 24.5%(4 924/20 124)(χ2=9 886.401, P<0.01). The detection rates of gastric polyps in age groups<20, 20-39, 40-59 and ≥60 were 1.8%(23/1 302), 1.8%(399/22 600), 3.4%(1 137/33 087)and 4.5%(566/12 586), respectively (χ2=238.867, P<0.01); and those for colorectal polyps were 6.6%(14/211), 11.6%(623/5 385), 26.0%(2 622/10 070)and 37.3%(1 665/4 458), respectively (χ2=934.724, P<0.01). The detection rates of gastric polyps in age groups 20-39, 40-59 and ≥60 were lower than those in colorectal polyps(all P<0.01). The detection rate of gastric polyps in males was lower than that in females(2.3%, 848/36 447 vs. 3.9%, 1 277/33 128, χ2=273.807, P<0.01), while the detection rate of colorectal polyps in males was higher than that in females (28.8%, 3 239/11 230 vs. 18.9%, 1 685/8 894, χ2=262.518, P<0.01). Diarrhea and gastrointestinal bleeding in patients with colorectal polyps was more common than those in patients with gastric polyps (23.5%, 1 156/4 924 vs. 2.5%, 54/2 125, χ2=558.080, P<0.01; 12.1%, 597/4 924 vs. 2.4%, 51/2 125, χ2=168.150, P<0.01). Single polyps were more common in gastric polyps than colorectal polyps(80.7%, 1 714/2 125 vs. 67.6%, 3 331/4 924, χ2=186.337, P<0.01). Polyps with size ≥1.0 cm were more common in colorectal polyps than those in gastric polyps (24.3%, 1 197/4 924 vs. 13.6%, 289/2 125, χ2=102.333, P<0.01). The proportion of inflammatory and hyperplastic types in gastric polyps was higher than that in colorectal polyps (67.1%, 1 378/2 125 vs. 27.5%, 1 273/4 924, χ2=934.394, P<0.01; 26.9%, 552/2 125 vs. 9.9%, 459/4 924, χ2=319.588, P<0.01); while the proportion of adenoma and canceration in gastric polyps was lower than that in colorectal polyps (1.7%, 34/2 125 vs. 62.4%, 2 893/4 924, χ2=2 135.743, P<0.01; 0.4%, 9/2 125 vs. 4.8%, 221/4 924, χ2=80.362, P<0.01). Conclusions In comparison with gastric polyps, the detection rate of colorectal polyps is higher. The detection rate of gastric polyps is higher in females, while that of colorectal polyps is higher in males. The detection rates of gastric polyps and colorectal polyps increase with the age. The main pathological type of gastric polyps is inflammatory, while that of colorectal polyps is adenoma.The canceration of colorectal polyps is more common than that of gastric polyps. Key words: Polyps; Stomach; Intestine, large; Disease attributes

Diagnosis and Management of Gastric Polyps

A gastric polyp is defined as a proliferative or neoplastic lesion from the mucosal membrane. Rates of gastric polyp detection are increasing due to widespread use of gastrointestinal endoscopy in Korea. There are many types of gastric polyps; the most common are fundic gland, hyperplastic, and adenomatous polyps. This article reviews the clinical and histologic features of these polyps and provides recommendations for management. Keywords: Stomach; Polyps; Diagnosis; Disease management 중심 단어: 위; ìš©ì¢ ; 진단; 치료

Sa1870 Fundic Gland Polyps With Dysplasia

Fundic gland polyps (FGPs) are the most common type of gastric polyp and are seen in up to 5% of patients on endoscopy. Although considered benign, FGPs are more common in patients with familial adenomatous polyposis (FAP). FGPs occur sporadically in up to 1.9% of the general population and in 84% of patients with syndromic FAP. Dysplasia in FGP is reported in 53% of syndromic FGPs and in only 2.3% of sporadic FGPs. The aim of this study is to compare patients with FGPs with dysplasia and those with FGPs without dysplasia. The pathology files from two institutions were searched from 1/1/2009 to 10/1/2013 for FGPs with dysplasia (FGPD). A similar number of control cases of FGP with no dysplasia (FGPND) were also randomly retrieved. All biopsies were reviewed, and diagnoses were agreed upon by three pathologists. Patient demographic data was recorded and included age, gender, race, diagnosis of FAP, and PPI use. Twenty-five patients with FGPD were identified (Male: 15, Female: 10, mean age: 60). Five patients had a confirmed history of FAP (mean age: 36), 9 had a high probability of FAP based on family or personal GI history (mean age: 61), 3 had no indication of FAP (such as family or personal history of colon cancer or polyps) (mean age: 63), and in 8 patients the family or personal history was not recorded (mean age: 62). Seventeen patients (68%) were on a protein pump inhibitor (PPI). The mean age of FGPD patients with FAP is significantly lower than patients without FAP (p< 0.001). The 26 patients with FGPND included 10 males and 16 females (mean age: 60). None of the patients had a history of FAP, 12 had a high probability of FAP based on family or personal GI history (mean age: 61), 6 had no indication of FAP (mean age: 59), and in 8 patients the family or personal history was not recorded (mean age: 55). Eighteen patients (69%) were on a PPI. There were no ethnic/racial differences between the two groups of patients. Of all biopsies from patients with FGPD, 88% of all fragments were smaller than 5 mm2 and 5% were greater than10 mm2. In contrast, of all the biopsies from patients with FGPND, 68% of all fragments were smaller than 5 mm2 and 20% were greater than 10 mm2. These data show no correlation between PPI use and the presence of low grade dysplasia in FGP. FGPND tended to result in larger biopsy fragments than FGPD; however there was no significant difference in the number of polyps described endoscopically between the two groups. Patients who have low-grade dysplasia in FGP are more likely to have FAP or a high probability of FAP than those without dysplasia. Low grade dysplasia in FGP is seen at a younger age in patients with FAP than in those without FAP. Finding low grade dysplasia in FGP, particularly in patients younger than 40 years, should raise a suspicion for FAP.

Gastric outlet obstruction due to a giant antral polyp which have malignant transformation

Introduction: Gastric polyps are seen 2–3% in all gastrointestinal endoscopic examinations. Hyperplastic polyps, the most common type of gastric polyps, are present 85–90% of cases. Giant villous tumors of the stomach are somewhat rare and the high incidence of malignant transformation of them requires prompt diagnosis. Giant gastric polyps can also cause gastrointestinal bleeding that leads to iron deficiency anemia or partial gastric outlet obstruction. All giant polyps must be resected endoscopically or surgically and still there are no marked

Expression of Foxa2 and its early alarm value of cancerous in gastric polyps

To explore the expression of Foxa2 in different pathological types of gastric polyps and examine the correlation with cancerous risk. According to computerize random number, a total of 2000 patients were selected to receive endoscopic biopsy during November 2011 to October 2012. Tissues were harvested from 170 with gastric polyps and suspicious cancerous lesions and their histological types detected. There were hyperplastic polyps(n = 35), adenomatous polyps(n = 31), fundic gland polyps(n = 42), advanced gastric cancer tissues (n = 32)and normal gastric mucosa tissues (n = 30). ABC immunohistochemical staining and reverse transcription(RT)-PCR were employed to detect the expression of Foxa2 in these different types of tissues. Imagepro plus was used for quantitative and statistical analyses. A low-level expression of Foxa2 was 3.6% ± 1.3% in normal gastric mucosa group. And its expreesion gradually higher in proliferative inflammatory polyp group(33.1% ± 8.0%), adenomatous polyp group (71.4% ± 1.7%) and gastric cancer group(96.3% ± 0.9%, all P < 0.05). Its expression was 35.6% ± 5.6% in fundic gland polyps, similar to that of proliferative inflammatory polyp group (P > 0.05), it was markedly lower than the gastric cancer group (P < 0.05) and higher than the normal gastric mucosa group (P < 0.05). Correlation analyses of clinicopathological parameters showed that no significant correlation existed between its expression and patient gender, age, predilection, Helicobacter. pylori infection or proton pump inhibitor used (all P > 0.05). However, the size of polyps was correlated with Foxa2 (rs = 0.69, P < 0.05). The expression level of Foxa2 in different types of gastric polyps may be used as a clinical predicator of polyps risk.

Histopathological features of canine spontaneous non-neoplastic gastric polyps - a retrospective study of 15 cases.

Fifteen cases of canine gastric polyps, collected over a 4-year period, were investigated using gross inspection, histological procedures and immunohistochemical techniques for Helicobacter infection. No breed or sex predisposition was found for gastric polyps, although they occurred mainly in elderly animals. There were 9 pedunculated and 6 sessile polypoid growths, between 5 to 30 mm in diameter developed mainly in the pyloric region of the stomach. The most common type of gastric polyps was the hyperplastic one. The inflammatory type was identified in three cases. Foci of AB/PAS Goblet positive cells resembling intestinal metaplasia, mild dysplasia of gastric epithelium, well delimited calcified areas, islands of osteoid matrix and nematodes were present in some of these lesions. Histological examination of the adjacent gastric polyp (surrounding gastric mucosa) revealed a severe chronic inflammation in 13 cases and a high grade of Helicobacter species colonization in all cases, but Kendall test analysis showed no correlation between Helicobacter spp. colonization degree and gastritis scores (τ = 0289; p = 0.204). A significant correlation was found between Helicobacter spp. location and gastritis scores (τ = 0.497; p = 0.035). Immunohistochemistry performed with a polyclonal antibody confirmed Helicobacter spp. infection in all cases. Based on their morphology, Helicobacter pylori - like organisms were described in 3 of 15 cases. No high degree of dysplasia nor neoplasia were identified in these lesions. The etiology and pathogenesis of gastric polyps in dogs are still unknown, although a severe chronic antral gastritis may be a predisposing condition for development of gastric polyps in dogs.

Endoscopic Ultrasonographic Assessment of Gastric Polyps and Endoscopic Mucosal Resection

Gastric polyps refer to a heterogeneous group of epithelial- and subepithelial-based lesions that vary in histology and malignant potential. Although many gastric polyps have characteristic endoscopic appearances, their diagnosis, classification, and potential for malignant transformation are based on histologic evaluation. Therefore, all types of gastric polyps should be biopsied during the incident endoscopy. Mucosal-based polyps include fundic gland polyps, hyperplastic polyps, adenomatous polyps, and hamartomatous polyps. Inflammatory fibroid polyps may endoscopically appear similar to mucosal-based polyps but actually arise from the submucosa. Certain types of polyps are associated with genetic syndromes or potential precancerous conditions (gastric intestinal metaplasia and chronic atrophic gastritis). If dysplasia is present and the polyp is ≥2cm or symptomatic, the polyp should be endoscopically resected with the aim of en bloc resection. There are limited data on the use of adjunctive endoscopic ultrasound (EUS) in the evaluation of mucosal-based gastric polyps, and therefore, is not routinely employed in the management of these lesions. EUS is recommended for the evaluation of gastric subepithelial lesions.

Mo1562 Inflammatory Fibroid Polyp of the Stomach: Clinical and Pathologic Characteristics of 28 Consecutive Cases Seen Over a 44-Month Period

Purpose: Gastric adenomas of intestinal differentiation are much more common than the more recently described adenomas of gastric differentiation. The purpose of this study was to compare the incidence and age at which adenomas of gastric phenotype occur compared to the more common intestinal type gastric adenomas. Methods: We used a large national pathology database of patients who undergo upper endoscopy at community-based surgery centers to determine the relative prevalence and associations of gastric foveolar adenomas, pyloric gland adenomas, and intestinal type adenomas. We extracted pertinent demographic, clinical, endoscopic, and histopathologic information from all patients who had a diagnosis of one of these three types of gastric polyps between 1/1/2008 and 11/1/2011. Frequency distributions and simple odd ratios were used to determine the significance of the associations. Results: From a total of 640,991 patients who underwent upper endoscopy (median age 58 years; 59.8% women), we identified a total of 549 with a diagnosis of gastric adenoma. Of those 443 (81%) were intestinal type, 77 (14%) were foveolar adenomas, and 29 (5%) were pyloric gland adenomas. In each case, the diagnosis was made on H&E stain. Intestinal-type gastric adenomas resembled colonic adenomas with loss of mucin, enlarged and elongated pseudostratified nuclei, and typically associated intestinal metaplasia with Paneth cells. Pyloric gland adenomas were composed of densely packed pyloric glands lined by cuboidal or short columnar cells, and a, typically, unremarkable surface epithelium. Foveolar adenomas featured a surface-predominant villous or papillary architecture with larger than normal foveolar cells and elongated nuclei. There was no significant difference between the median age of the different type of polyps (72 years for intestinal type, 77 for foveolar, and 73 for pyloric gland). There was, however, a significant predominance of women (86.2%) among pyloric gland adenomas (OR=3.86, p<0.01), but not among foveolar adenomas (55.8% women). A small fraction of the study group was known to have FAP (3.4% of intestinaltype adenomas, 2.6% of foveolar adenomas, and none of pyloric gland adenomas). Conclusion: Among a large nationwide population with endoscopy and biopsy for gastric adenomas, intestinal-type adenomas predominate, but almost 20% are of gastric phenotype and may be under-recognized. Our data also reaffirms previous studies that demonstrate a female predominance among pyloric gland adenomas.

Mo1561 The Gastric Phenotype Adenomas (Foveolar and Pyloric Gland Adenomas): Incidence at a National Reference GI Practice

Purpose: Gastric adenomas of intestinal differentiation are much more common than the more recently described adenomas of gastric differentiation. The purpose of this study was to compare the incidence and age at which adenomas of gastric phenotype occur compared to the more common intestinal type gastric adenomas. Methods: We used a large national pathology database of patients who undergo upper endoscopy at community-based surgery centers to determine the relative prevalence and associations of gastric foveolar adenomas, pyloric gland adenomas, and intestinal type adenomas. We extracted pertinent demographic, clinical, endoscopic, and histopathologic information from all patients who had a diagnosis of one of these three types of gastric polyps between 1/1/2008 and 11/1/2011. Frequency distributions and simple odd ratios were used to determine the significance of the associations. Results: From a total of 640,991 patients who underwent upper endoscopy (median age 58 years; 59.8% women), we identified a total of 549 with a diagnosis of gastric adenoma. Of those 443 (81%) were intestinal type, 77 (14%) were foveolar adenomas, and 29 (5%) were pyloric gland adenomas. In each case, the diagnosis was made on H&E stain. Intestinal-type gastric adenomas resembled colonic adenomas with loss of mucin, enlarged and elongated pseudostratified nuclei, and typically associated intestinal metaplasia with Paneth cells. Pyloric gland adenomas were composed of densely packed pyloric glands lined by cuboidal or short columnar cells, and a, typically, unremarkable surface epithelium. Foveolar adenomas featured a surface-predominant villous or papillary architecture with larger than normal foveolar cells and elongated nuclei. There was no significant difference between the median age of the different type of polyps (72 years for intestinal type, 77 for foveolar, and 73 for pyloric gland). There was, however, a significant predominance of women (86.2%) among pyloric gland adenomas (OR=3.86, p<0.01), but not among foveolar adenomas (55.8% women). A small fraction of the study group was known to have FAP (3.4% of intestinaltype adenomas, 2.6% of foveolar adenomas, and none of pyloric gland adenomas). Conclusion: Among a large nationwide population with endoscopy and biopsy for gastric adenomas, intestinal-type adenomas predominate, but almost 20% are of gastric phenotype and may be under-recognized. Our data also reaffirms previous studies that demonstrate a female predominance among pyloric gland adenomas.

Association between Runx3 protein expression and Helicobacter pylori infection in different types of gastric polyps and gastric cancer

Association between Runx3 protein expression and Helicobacter pylori infection in different types of gastric polyps and gastric cancer

Trefoil Peptides, E-cadherin, and β-catenin Expression in Sporadic Fundic Gland Polyps

Sporadic fundic gland polyps (FGP) are the most common type of gastric polyps and their pathogenesis is still unclear, although a beta-catenin gene mutation has been described. They are regarded as benign lesions but low-grade dysplasia has been observed, arising more debate on their potential progression to a malignant phenotype. We investigated in FGP the role of factors involved in cell integrity, proliferation, and intercellular adhesion: trefoil peptides (TFF1, TFF2), MIB1, E-cadherin, and beta-catenin. We selected randomly 24 patients with FGP, 24 with normal gastric mucosa and 12 with atrophic gastritis with diffuse intestinal metaplasia (IM-gastritis), all Helicobacter pylori negative. The expression of all factors was examined by immunohistochemistry. In polyps and normal mucosa, TFF1 is expressed only in foveolar compartment whereas in IM-gastritis the signal is reduced in all the compartments. TFF2 is expressed in polyps and normal mucosa, in proliferative and basal compartment, whereas in IM-gastritis the expression is reduced or absent. E-cadherin is expressed in the entire zone: with a medium signal in normal mucosa and polyps, and weaker in IM-gastritis. The beta-catenin's signal in normal mucosa and polyps is moderate-to-intense in proliferative and basal compartments, whereas in IM-gastritis signal is significantly reduced in all the compartments. MIB1 in normal mucosa and polyps is expressed only in proliferative compartment, whereas its expression is stronger in IM-gastritis and involves also basal compartment. In conclusion all the factors considered were normally expressed in FGP and this, especially considered against the findings in IM-gastritis, supports the benign nature of FGP.