Abstract
Background
Gastric polyps represent an abnormal proliferation of the gastric mucosa. Chronic
atrophic autoimmune gastritis (CAAG) targets parietal cells and results in hypo-achlorhydria
and hypergastrinemia, which exerts a proliferative effect on the gastric mucosa.
Aims
We investigate the incidence of gastric polyps in CAAG patients.
Methods
This is a single-center retrospective study examining patients with confirmed CAAG
from January 1990 until June 2022. Demographic, clinical, biochemical, and serological
data were collected for each included patient. The histopathological characteristics
of the detected polyps were recorded.
Results
A total of 176 CAAG patients were included. Eighty-nine (50.5%) had 163 incidental
polyps. Seventy-six patients (85%) had 130 non-endocrine lesions, among which 118
(90.7%) were inflammatory, 6 (4.6%) adenomatous, and 4 (3%) fundic; 33 patients (37%)
had gastric neuroendocrine neoplasms (gNENs), and 21 (23.6%) both; one had MALToma
and one gastric adenocarcinoma. Higher circulating levels of gastrin and chromogranin
A were observed among patients with polyps (median 668 vs 893 pg/ml p = 0.0237, 146 vs 207 ng/ml p = 0.0027, respectively).
Conclusion
CAAG implies a high incidence of gNENs and exocrine lesions. Gastrin plays a possible
trophic role on the mucosa. Further evidence is needed to validate its predictive
role for increased polyp risk in CAAG.
Keywords
Abbreviations:
GPs (gastric polyps), gNENs (gastric neuroendocrine neoplasms), EGD (esophagogastroduodenoscopy), H. Pylori (Helicobacter pylori), PPIs (proton pump inhibitors), CAAG (chronic autoimmune atrophic gastritis), APCA (anti-parietal cell antibodies), IF (intrinsic factor), PG-I (pepsinogen I), BMI (body mass index), PGS (polyglandular syndrome), EMR (endoscopic mucosal resection), EUS (endoscopic ultrasonography), ESD (endoscopic submucosal dissection), OLGA (Operative Link on Gastritis Assessment), OLGIM (Operative Link on Gastric Intestinal Metaplasia), CgA (chromogranin A), SYN (synaptophysin), EDTA (ethylenediaminetetraacetic acid), MCV (mean corpuscular volume), LDH (lactate dehydrogenase), RIA (radiommunoassay), PBC (primary biliary cholangitis), AIH (autoimmune hepatitis), SLE (Systemic Lupus Erythematosus)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 27, 2023
Accepted:
February 14,
2023
Received:
October 31,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
