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World J Gastrointest Oncol. Jul 15, 2021; 13(7): 662-672
Published online Jul 15, 2021. doi: 10.4251/wjgo.v13.i7.662
Sporadic fundic gland polyps with dysplasia or carcinoma: Clinical and endoscopic characteristics
Wataru Sano, Fumihiro Inoue, Daizen Hirata, Mineo Iwatate, Santa Hattori, Mikio Fujita, Yasushi Sano
Wataru Sano, Fumihiro Inoue, Daizen Hirata, Mineo Iwatate, Santa Hattori, Mikio Fujita, Yasushi Sano, Gastrointestinal Center, Sano Hospital, Kobe 655-0031, Hyogo, Japan
Author contributions: Sano W wrote the manuscript; Inoue F, Hirata D, Iwatate M, Hattori S, Fujita M, and Sano Y reviewed the manuscript and approved the final version.
Conflict-of-interest statement: The authors declare no conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wataru Sano, MD, Doctor, Gastrointestinal Center, Sano Hospital, 2-5-1 Shimizugaoka, Tarumi, Kobe 655-0031, Hyogo, Japan. watasano@yahoo.co.jp
Received: February 7, 2021
Peer-review started: February 7, 2021
First decision: April 19, 2021
Revised: April 25, 2021
Accepted: June 2, 2021
Article in press: June 2, 2021
Published online: July 15, 2021
Processing time: 153 Days and 6 Hours
Abstract

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.

Keywords: Sporadic; Fundic gland polyp; Dysplasia; Carcinoma; Proton pump inhibitor; Helicobacter pylori

Core Tip: Majority of the patients harboring sporadic fundic gland polyps with dysplasia or carcinoma were middle-aged women receiving proton pump inhibitor therapy who did not have Helicobacter pylori infection. Majority of the sporadic fundic gland polyps with dysplasia or carcinoma occurred in the body of the stomach and were sessile and small with a mean size of 5.4 mm. The sporadic fundic gland polyps 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.