Stolte Manfred, Vieth Michael, Ebert Matthias P
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
Eur J Gastroenterol Hepatol. 2003 Nov;15(11):1153-6. doi: 10.1097/00042737-200311000-00001.
Sporadic fundic gland polyps (FGPs) are the most frequent gastric polyps. These FGPs develop almost exclusively in a normal corpus mucosa without Helicobacter pylori infection. This means that they represent an absolutely benign disease (no ulcers, almost no gastric carcinoma and mucosa associated lymphoid tissue (MALT) lymphoma). Most probably there exists a statistically accumulated coincidence rate of sporadic FGPs with colorectal epithelial neoplasias, so it is recommended to consider preventive colonoscopy. In familial adenomatous polyposis (FAP), FGPs are present in up to 80-93% of patients. In such patients, low-grade dysplasia and/or foveolar microadenomas may be present in 44-54% of cases. To date, only three case reports on early gastric carcinoma have been published. In this issue, to the best of our knowledge the first case of a high-grade dysplasia (intraepithelial neoplasia) in a sporadic FGP is reported. Recently, it has been shown that beta-catenin mutations might have led to FGP. Therefore, in the future, patients showing nuclear beta-catenin expression must undergo examination to discover whether this expression may lead to neoplasia. According to the data available at present, such a constellation must be regarded as an extremely rare event.
散发性胃底腺息肉（FGPs）是最常见的胃息肉。这些FGPs几乎仅在无幽门螺杆菌感染的正常胃体黏膜中发生。这意味着它们代表一种绝对良性的疾病（无溃疡，几乎无胃癌及黏膜相关淋巴组织（MALT）淋巴瘤）。散发性FGPs与结直肠上皮肿瘤之间很可能存在统计学上的累积巧合率，因此建议考虑进行预防性结肠镜检查。在家族性腺瘤性息肉病（FAP）患者中，FGPs的发生率高达80% - 93%。在这类患者中，44% - 54%的病例可能存在低级别异型增生和/或腺窝微腺瘤。迄今为止，仅发表了3例早期胃癌的病例报告。在本期中，据我们所知，首次报道了散发性FGP中发生高级别异型增生（上皮内瘤变）的病例。最近研究表明，β-连环蛋白突变可能导致FGP。因此，未来对于显示核β-连环蛋白表达的患者，必须进行检查以确定这种表达是否可能导致肿瘤形成。根据目前可得的数据，这种情况必须被视为极其罕见的事件。
