Clinical Gastroenterology and Hepatology
Volume 7, Issue 8 , Pages 849-854, August 2009

No Association Between Gastric Fundic Gland Polyps and Gastrointestinal Neoplasia in a Study of Over 100,000 Patients

  • Robert M. Genta

      Affiliations

    • Division of Gastrointestinal Pathology, Caris Diagnostics, Irving, Texas
    • Departments of Pathology and Medicine, Veterans Affairs North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas, Texas
    • Corresponding Author InformationReprint requests Address requests for reprints to: Robert M. Genta, MD, Dallas VAMC, Pathology and Medicine (Gastroenterology), 4500 South Lancaster Road, Dallas, Texas 75216. fax: (214) 596-2297
    • ,
  • Christopher M. Schuler

      Affiliations

    • Division of Gastrointestinal Pathology, Caris Diagnostics, Irving, Texas
    • ,
  • Cristian I. Robiou

      Affiliations

    • Division of Gastrointestinal Pathology, Caris Diagnostics, Irving, Texas
    • ,
  • Richard H. Lash

      Affiliations

    • Division of Gastrointestinal Pathology, Caris Diagnostics, Irving, Texas

published online 25 May 2009.

Background & Aims

Fundic gland polyps (FGPs), the most common type of gastric polyps, have been associated with prolonged proton pump inhibitor therapy and an increased risk of colon cancer. The presence of FGPs has been inversely correlated with Helicobacter pylori infection. We evaluated the prevalence of H pylori-associated gastritis, colonic polyps, and carcinomas in subjects with and without FGPs.

Methods

We analyzed data collected from community-based endoscopy centers in 36 states (plus Washington DC and Puerto Rico) on patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy between April 2007 and March 2008. Of the 103,385 patients who underwent EGD during this time period, gastric biopsy samples were collected from 78,801 and colonic biopsies from 26,017. Slides of samples from Helicobacter-infected FGPs and FGPs with dysplasia were reviewed.

Results

FGPs were detected in 6081 patients (67.8% women). Helicobacter infection was present in less than 0.5% patients with FGPs and 13.0% of those without FGPs (odds ratio [OR], 29.05; 95% confidence interval [CI], 20.4–41.4; P < .0001). Colonic adenomas were detected in 42.3% of women with FGPs and 33.8% of those without (OR, 1.43; 95% CI, 1.26–1.63; P < .001); there was no significant difference in colonic adenomas between men with and without FGPs.

Conclusions

Women had a higher prevalence of FGPs. FGPs were associated with gastroesophageal reflux disease symptoms, gastric heterotopia, hyperplastic colonic polyps (only in men), and colonic adenomas (only in women, especially those over 60 years of age). The presence of FGPs was inversely correlated with H pylori infection, active gastritis, and gastric neoplasia.

Abbreviations used in this paper: CI, confidence interval, EGD, esophagogastroduodenoscopy, FGP, fundic gland polyp, GERD, gastroesophageal reflux disease, OR, odds ratio, PPI, proton pump inhibitor, VBA, Visual Basics for Applications.

 

 Conflicts of interest The authors disclose no conflicts.

PII: S1542-3565(09)00448-0

doi:10.1016/j.cgh.2009.05.015

Clinical Gastroenterology and Hepatology
Volume 7, Issue 8 , Pages 849-854, August 2009