Fundic gland polyps(FGPs)are the most common gastric polyps and have been regarded as benign lesions with little malignant potential,except in the setting of familial adenomatous polyposis.However,in recent years,the ...Fundic gland polyps(FGPs)are the most common gastric polyps and have been regarded as benign lesions with little malignant potential,except in the setting of familial adenomatous polyposis.However,in recent years,the prevalence of FGPs has been increasing along with the widespread and frequent use of proton pump inhibitors(PPIs).To date,several cases of FGPs with dysplasia or carcinoma(FGPD/CAs)have been reported.In this review,we evaluated the clinical and endoscopic characteristics of sporadic FGPD/CAs.Majority of the patients with sporadic FGPD/CAs were middle-aged women receiving PPI therapy and without Helicobacter pylori(H.pylori)infection.Majority of the sporadic FGPD/CAs occurred in the body of the stomach and were sessile and small with a mean size of 5.4 mm.The sporadic FGPs with carcinoma showed redness,irregular surface structure,depression,or erosion during white light observation and irregular microvessels on the lesion surface during magnifying narrow-band imaging.In addition,sporadic FGPs,even with dysplasia,are likely to progress to cancer slowly.Therefore,frequent endoscopy is not required for patients with sporadic FGPs.However,histopathological evaluation is necessary if endoscopic findings different from ordinary FGPs are observed,regardless of their size.In the future,the prevalence of FGPs is expected to further increase along with the widespread and frequent use of PPIs and decreasing infection rate of H.pylori.Currently,it is unclear whether FGPD/CAs will also increase in the same way as FGPs.However,the trends of these lesions warrant further attention in the future.展开更多
Background Sporadic fundic gland polyps (FGPs) are common gastric polyps.Some studies reported that FGPs dramatically increased due to proton pump inhibitors (PPIs) use and a decreased prevalence of Helicobacter p...Background Sporadic fundic gland polyps (FGPs) are common gastric polyps.Some studies reported that FGPs dramatically increased due to proton pump inhibitors (PPIs) use and a decreased prevalence of Helicobacter pylori (H.pylon) infection in Western countries.However,data are still controversial.This study aimed to identify the relationships between these two factors and FGPs in China.Methods Consecutive patients with FGPs detected were retrospectively analyzed.Data including patients' age,sex,symptoms,H.pylori infection,history of PPIs use,and the polyps were documented.Each patient was compared with two randomly selected age-and sex-matched controls with similar symptoms in the same period.Results During the period from March 2011 to March 2012,a total of 328 patients were diagnosed as FGPs in 23 047 patients who underwent routine esophagogastroduodenoscopy and 656 patients without FGPs as controls.The mean age was (55.12±12.61) years,and 75.91% were women.The prevalence of H.pylori in patients with FGPs was significantly lower than in those without FGPs (22.30% (64/287) vs.42.26% (224/530),P <0.001,OR 0.392,95% Cl 0.283-0.544).Overall,a total of 54 patients with FGPs (54/328,16.46%) and 136 patients without FGPs (136/656,20.73%) received PPIs therapy (P=0.110).According to the different duration of PPIs use,no significant differences of PPIs use were found between the cases and controls among all subgroups.Moreover,the PPIs use was also similar,regardless of age,sex,H.pylori infection,and the number of polyps.Conclusion Sporadic FGPs may not be induced by PPIs therapy but negatively correlate with H.pylori infection in China,which is not the same with the data in Western countries.展开更多
Sporadic fundic gland polyps (FGPs) account for 0.8%- 1.9% of all gastric polyps and are observed in patients undergoing esophagogastroduodenoscopy (EGD) in whom they account for more than 50% of all gastric polyp...Sporadic fundic gland polyps (FGPs) account for 0.8%- 1.9% of all gastric polyps and are observed in patients undergoing esophagogastroduodenoscopy (EGD) in whom they account for more than 50% of all gastric polyps. The prevalence is increasing in recent years possibly due to decreased Helicobacter pylori (1t. pylori) infection rate and long-term proton pump inhibitor use. Generally, sporadic FGPs are assumed to be benign polyps with no risk of malignant transformation. We evaluated the feasibility of predicting sporadic FGPs based on typical endoscopic appearance in a large database of 47 771 endoscopies.展开更多
文摘Fundic gland polyps(FGPs)are the most common gastric polyps and have been regarded as benign lesions with little malignant potential,except in the setting of familial adenomatous polyposis.However,in recent years,the prevalence of FGPs has been increasing along with the widespread and frequent use of proton pump inhibitors(PPIs).To date,several cases of FGPs with dysplasia or carcinoma(FGPD/CAs)have been reported.In this review,we evaluated the clinical and endoscopic characteristics of sporadic FGPD/CAs.Majority of the patients with sporadic FGPD/CAs were middle-aged women receiving PPI therapy and without Helicobacter pylori(H.pylori)infection.Majority of the sporadic FGPD/CAs occurred in the body of the stomach and were sessile and small with a mean size of 5.4 mm.The sporadic FGPs with carcinoma showed redness,irregular surface structure,depression,or erosion during white light observation and irregular microvessels on the lesion surface during magnifying narrow-band imaging.In addition,sporadic FGPs,even with dysplasia,are likely to progress to cancer slowly.Therefore,frequent endoscopy is not required for patients with sporadic FGPs.However,histopathological evaluation is necessary if endoscopic findings different from ordinary FGPs are observed,regardless of their size.In the future,the prevalence of FGPs is expected to further increase along with the widespread and frequent use of PPIs and decreasing infection rate of H.pylori.Currently,it is unclear whether FGPD/CAs will also increase in the same way as FGPs.However,the trends of these lesions warrant further attention in the future.
基金This study was supported by grants from the National Natural Science Foundation of China (No.81300272 and No.81070283),Research Fund for the Doctoral Program of Higher Education of China (No.20121202110018),and Tianjin Research Program of Application Foundation and Advanced Technology of China (No.13JCQNJC10600).
文摘Background Sporadic fundic gland polyps (FGPs) are common gastric polyps.Some studies reported that FGPs dramatically increased due to proton pump inhibitors (PPIs) use and a decreased prevalence of Helicobacter pylori (H.pylon) infection in Western countries.However,data are still controversial.This study aimed to identify the relationships between these two factors and FGPs in China.Methods Consecutive patients with FGPs detected were retrospectively analyzed.Data including patients' age,sex,symptoms,H.pylori infection,history of PPIs use,and the polyps were documented.Each patient was compared with two randomly selected age-and sex-matched controls with similar symptoms in the same period.Results During the period from March 2011 to March 2012,a total of 328 patients were diagnosed as FGPs in 23 047 patients who underwent routine esophagogastroduodenoscopy and 656 patients without FGPs as controls.The mean age was (55.12±12.61) years,and 75.91% were women.The prevalence of H.pylori in patients with FGPs was significantly lower than in those without FGPs (22.30% (64/287) vs.42.26% (224/530),P <0.001,OR 0.392,95% Cl 0.283-0.544).Overall,a total of 54 patients with FGPs (54/328,16.46%) and 136 patients without FGPs (136/656,20.73%) received PPIs therapy (P=0.110).According to the different duration of PPIs use,no significant differences of PPIs use were found between the cases and controls among all subgroups.Moreover,the PPIs use was also similar,regardless of age,sex,H.pylori infection,and the number of polyps.Conclusion Sporadic FGPs may not be induced by PPIs therapy but negatively correlate with H.pylori infection in China,which is not the same with the data in Western countries.
基金This study was supported by grants from the National Natural Science Foundation of China,Tianjin Research Program of Application Foundation and Advanced Technology for Young Scientists
文摘Sporadic fundic gland polyps (FGPs) account for 0.8%- 1.9% of all gastric polyps and are observed in patients undergoing esophagogastroduodenoscopy (EGD) in whom they account for more than 50% of all gastric polyps. The prevalence is increasing in recent years possibly due to decreased Helicobacter pylori (1t. pylori) infection rate and long-term proton pump inhibitor use. Generally, sporadic FGPs are assumed to be benign polyps with no risk of malignant transformation. We evaluated the feasibility of predicting sporadic FGPs based on typical endoscopic appearance in a large database of 47 771 endoscopies.