Gastric Fundic Gland Polyps and Their Relationship to Colorectal Neoplasia in Koreans: A 16-year Retrospective Study

Sun-Mee Hwang; Byung-Wook Kim; Hiun-Suk Chae; Bo-In Lee; Hwang Choi; Jeong-Seon Ji; Kyu-Yong Choi; In-Sik Chung; d Lee-So Maeng

doi:10.4166/kjg.2011.58.1.20

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Hwang, Kim, Chae, Lee, Choi, Ji, Choi, Chung, and Maeng: Gastric Fundic Gland Polyps and Their Relationship to Colorectal Neoplasia in Koreans: A 16-year Retrospective Study

Original Article

Korean J Gastroenterol 2011;58(1):20-24.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.58.1.20

Gastric Fundic Gland Polyps and Their Relationship to Colorectal Neoplasia in Koreans: A 16-year Retrospective Study

Sun-Mee Hwang, Byung-Wook Kim, Hiun-Suk Chae, Bo-In Lee, Hwang Choi, Jeong-Seon Ji, Kyu-Yong Choi, In-Sik Chung, d Lee-So Maeng¹

Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea

¹Department of Pathology, The Catholic University of Korea, College of Medicine, Seoul, Korea

Correspondence to: Byung-Wook Kim, Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, 665, Pupyong-dong, Pupyong-gu, Incheon 403-720, Korea. Tel: +82-32-510-5500, Fax: +82-32-510-5683, E-mail: gastro@catholic.ac.kr

Received 29 December 201014 March 2011 Accepted 15 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

There is an ongoing debate on the relationship between gastric fundic gland polyps and increased incidence of colorectal neoplasia in Caucasians. However, there was no report on the relationship between gastric fundic gland polyp and colorectal neoplasia in Korea. The aim of this study was to identify the characteristics of gastric fundic gland polyps and whether a relationship exists between fundic gland polyps and colorectal neoplasia in Korean population.

Methods

Persons who underwent an esophagogastroduodenoscopy and colonoscopy from 1992 to 2007 at the Health Promotion Center of Incheon St. Mary's Hospital, The Catholic University of Korea were reviewed retrospectively. The relationship between gastric fundic gland polyps and colorectal neoplasia were analyzed.

Results

Among 22,451 subjects, fundic gland polyps were found in 328 subjects (1.5%). Fundic gland polyps were more common in women than in men (odds ratio of 6.25; 95% CI of 4.68-8.34). The odds ratios for colorectal neoplasia in all subjects with gastric fundic gland polyps were 0.56 (95% CI of 0.33-0.95) and men who were 50 years of age or older had an odds ratio of 2.81 (95% CI of 1.03-7.66) as compared to the control group. However, age and sex-adjusted odds ratios for all gastric fundic gland polyps were 0.73 (95% CI of 0.42-1.26), for men 1.78 (95% CI of 0.80-3.98), and for women 0.37 (95% CI of 0.16-0.87).

Conclusions

Surveillance colonoscopy in patients with fundic gland polyps can be performed in the same manner as general population in Korea.

Keywords: Gastric fundus, Polyps, Colorectal neoplasms

References

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Fig. 1.

A representative case of fundic gland polyp. (A) On esophagogastroduodenoscopy, a polypoid lesion was found on the fundus dome of the stomach. (B) On histopathology, cystically dilated and irregularly budded fundic glands were found (H&E stain, ×40).

Table 1.

Demographic Data of Subjects in the Gastric Fundic Gland Polyp Group and the Control Group

	Gastric FGP group	Control group
Total number of patients Mean age, yr (±SD)^a	15848.5 (±13.1)	2,356 47.8 (±10.4)
No. of males: No. of females ^b	29:1,209	1,397:959
Number of patients with colorectal neoplasia	16 (10.1%)	394 (16.7%)

FGP, fundic gland polyp.

^a p=0.50.

^b p<0.001.

Table 2.

Odds Ratio of Colorectal Neoplasia in the Fundic Gland Polyp Group and the Control Group

	Gastric FGP group (%)	Control group (%)	Odds ratio (95% CI)	p-value
Total	16/158 (10.1)	394/2356 (16.7)	0.56 (0.33-0.95)	0.03
Male	10/29 (34.5)	283/1397 (20.3)	2.07 (0.95-4.50)	0.06
<50	1/13 (7.7)	113/859 (13.2)	0.54 (0.07-4.23)	0.31
≥50	9/16 (56.3)	170/538 (31.6)	2.81 (1.03-7.66)	0.04
Female	6/129 (4.7)	111/959 (11.6)	0.37 (0.16-0.87)	0.02
<50	2/73 (2.7)	41/531 (7.7)	0.33 (0.08-1.38)	0.11
≥50	4/56 (7.1)	70/428 (16.4)	0.40 (0.14-1.14)	0.08

FGP, fundic gland polyp.

Table 3.

Age and Sex-adjusted Odds Ratio of Colorectal Neoplasia in the Fundic Gland Polyp group and the Control Group

Odds ratio	95% CI	p-value
Total 0.73	0.42-1.26	0.25
Male 1.78	0.80-3.98	0.16
Female 0.37	0.16-0.87	0.02

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