OBJECTIVES: The development of fundic gland polyps (FGPs) is the most common side effect of long-term proton pump inhibitor (PPI) use; however, the effect of drug use characteristics and their impact on the risk of other gastric polyp development remain unclear. We aimed to identify the influence of PPI administration, as well as its duration and dose, in the development of gastric polyps. METHODS: A prospective cohort study was conducted on consecutive patients who underwent gastroscopy between September 2017 and August 2019. Detailed characteristics of gastric polyps, Helicobacter pylori infection, and PPI use were analyzed. RESULTS: Among the 2723 patients included, gastric polyps (75% FGPs, 22% hyperplastic) were detected in 16.4%, and 60% were prescribed PPI. The risk of FGPs and hyperplastic polyps according to the duration of PPI use were as follows: 2-5 years [odds ratio (95% confidence interval); 2.86 (2.00-4.11) and 2.82 (1.69-4.78)]; 6-9 years [7.42 (5.03-11.01) and 2.32 (1.05-4.78)]; ≥10 years [14.94 (10.36-21.80) and 3.52 (1.67-7.03)]. Multivariate analysis confirmed that the risk of FGPs was 17.16 (11.35-26.23) for ≥10 years of PPI use. Portal hypertension-related conditions were associated with hyperplastic polyps [4.99 (2.71-9.20)]. CONCLUSION: Duration of and indications for PPI use are the most predictive factors for the development of gastric polyps. Prolonged PPI use increases the risk of polyp development and the number of patients with polyps, which may burden endoscopic practice. Highly selected patients may require particular care despite minimal risk of dysplasia and bleeding generally.
- MeSH
- Gastroscopy MeSH
- Helicobacter pylori * MeSH
- Helicobacter Infections * complications drug therapy MeSH
- Proton Pump Inhibitors adverse effects MeSH
- Humans MeSH
- Stomach Neoplasms * chemically induced epidemiology complications MeSH
- Polyps * chemically induced epidemiology complications MeSH
- Prospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND AND AIMS: Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) has to date been recognized in only 8 families worldwide. Recently, different point mutations within the Ying Yang 1 (YY1) binding motif in promoter 1B of the APC gene were assigned as causal in 6 families with GAPPS. METHODS: We diagnosed GAPPS across 3 generations in a Czech white family. RESULTS: The proband's mother died of gastric cancer at 49 years of age. The proband died of gastric cancer at 56 years of age. All 3 of the proband's daughters inherited polyposis, involving exclusively the gastric fundus and body, with relative sparing of the lesser curve. The daughters have all been regularly surveyed endoscopically. Polyposis progressed rapidly with intestinal differentiated low-grade and high-grade dysplasia present on polypectomy specimens 5 years after the original diagnosis. On this basis, all 3 of the proband's daughters were scheduled for prophylactic total gastrectomy. Unfortunately, the middle daughter presented with generalized gastric adenocarcinoma and died at the age of 26 years. The other 2 daughters (aged 30 and 23 years) underwent total gastrectomy within 6 weeks of their sister's death; histology of surgical specimens showed gastric adenocarcinoma stage IA (pT1a, N0, M0) in both cases. Bi-directional Sanger sequencing of promoter 1B revealed a point mutation (c.-191 T>C) in all 3 daughters of the proband. CONCLUSIONS: Atypical endoscopic progression of the fundic gland polyposis, with the presence of dysplasia on polypectomy specimens and genetic testing with recently discovered mutations in promoter 1B of the APC gene might help clinicians to decide whether prophylactic gastrectomy should be performed.
- MeSH
- Adenocarcinoma complications genetics prevention & control MeSH
- Adenomatous Polyps complications genetics pathology surgery MeSH
- Adult MeSH
- Gastrectomy MeSH
- Gastroscopy MeSH
- Genes, APC * MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Mutation MeSH
- Stomach Neoplasms complications genetics pathology prevention & control surgery MeSH
- Polyps complications genetics pathology surgery MeSH
- Promoter Regions, Genetic MeSH
- Pedigree MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Review MeSH
Článek uvádí přehled hereditárních polypózních syndromů trávicího traktu, jejich podrobnější genetické mechanizmy. Stručně jsou uvedeny základní projevy onemocnění, včetně extragastrointestinálních znaků. Jsou uvedeny podstatné diagnostické postupy. Terapie těchto chorobných stavů je buď operační, nebo endoskopická.
The article provides an overview of hereditary polyposis syndromes of the digestive tract and genetic mechanisms in greater detail. A brief summary of the basic symptoms of the condition, including extra‑gastrointestinal signs, is given. Significant diagnostic procedures are listed. The therapy for these disease conditions is either operative or endoscopic.
- Keywords
- syndrom Peutzův-Tourainův-Jeghersův, MUTYH sdružená polypóza, atenuovaná polypóza, hyperplastická polypóza, juvenilní polypóza,
- MeSH
- Diagnostic Techniques, Digestive System MeSH
- Adenomatous Polyposis Coli * diagnosis genetics surgery complications MeSH
- Colectomy MeSH
- Humans MeSH
- Duodenal Diseases complications MeSH
- Stomach Diseases complications MeSH
- Peutz-Jeghers Syndrome diagnosis MeSH
- Colonic Polyps diagnosis surgery MeSH
- Polyps diagnosis surgery complications MeSH
- Intestinal Polyposis * diagnosis surgery physiopathology MeSH
- Check Tag
- Humans MeSH
Hysteroskopia je efektívna diagnostická a terapeutická metóda v intrauterinnej patológií, ktorá má zo všetkých dostupných diagnostických metodík najvyššiu senzitivitu a špecificitu. Hysteroskopia postupne nahrádza diagnostickú kyretáž, ktorá v porovnaní s hysteroskopiou neposkytuje adekvátnu diagnostiku organického nálezu v dutine maternice, prípadne riešenie intrauterinnej patológie diagnostickou kyretážou je skôr náhodné.
Hysteroscopy is an effective diagnostic and therapeutic methods of intrauterine pathology that has all of the available diagnostic methodologies highest sensitivity and specificity. Diagnostic hysteroscopy is gradually replacing curettage, which compared with hysteroscopy does not provide adequate diagnosis of organic findings in uterine cavity, and solution of intrauterine pathology diagnostic curettage is rather random.
- MeSH
- Tissue Adhesions surgery complications MeSH
- Anesthesia and Analgesia methods MeSH
- Biopsy MeSH
- Hysteroscopy classification contraindications methods MeSH
- Humans MeSH
- Myoma surgery complications MeSH
- Uterine Diseases diagnosis surgery pathology MeSH
- Polyps surgery complications MeSH
- Postoperative Complications MeSH
- Sterilization, Reproductive methods MeSH
- Endometrial Ablation Techniques methods MeSH
- Uterus surgery pathology MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Review MeSH
- MeSH
- Cricoid Cartilage physiology physiopathology pathology MeSH
- Endocrine System physiology pathology MeSH
- Glottis anatomy & histology pathology MeSH
- Vocal Cords * physiology physiopathology pathology MeSH
- Larynx anatomy & histology pathology MeSH
- Humans MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Polyps complications MeSH
- Voice Disorders * pathology rehabilitation therapy MeSH
- Education, Special * methods MeSH
- Inflammation pathology MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- MeSH
- Asphyxia Neonatorum etiology MeSH
- Humans MeSH
- Pharyngeal Neoplasms MeSH
- Polyps complications pathology MeSH
- Check Tag
- Humans MeSH
