Original contributionImmunohistochemical evaluation of adenomatous polyposis coli, β-catenin, c-Myc, cyclin D1, p53, and retinoblastoma protein expression in syndromic and sporadic fundic gland polyps
Section snippets
Materials and methods
A total of 262 fundic gland polyps were included in this study. These included 155 syndromic polyps biopsied from 35 patients with FAP (27 cases) or Gardner’s syndrome (8 cases) retrieved from the 1988–2001 pathology archives at Washington University Medical Center, the 1990–2000 pathology archives at the University of Chicago Hospitals, and the University of Texas Medical Branch at Galveston. Also included in the study were 107 sporadic polyps that were randomly selected from 45 patients who
Clinicopathologic features of syndromic and sporadic FGPs
The mean ages of the patients with syndromic and sporadic FGPs were 32 years (range, 14 to 70) and 55 years (range, 12 to 85), with male-female ratios of 1.4:1 and 1:2.5, respectively. In sporadic cases, 14 patients (31%) had a documented clinical history of proton pump inhibitor use. Histologically, syndromic and sporadic FGPs were indistinguishable, characterized by the presence of cystically dilated fundic glands lined by an attenuated layer of parietal and chief cells (Fig 1A).
Discussion
Recent studies have shown that FGPs are clonal lesions and thus neoplastic in nature.6, 7, 8, 9, 10, 15 In these elegant studies, a high frequency of somatic mutations in the APC gene was detected in syndromic FGPs, whereas a high frequency of activating mutations in the β-catenin gene was found in sporadic cases. These findings are intriguing because mutations in the APC or β-catenin genes detected in other anatomic locations are always associated with a morphologically overt neoplastic
Acknowledgements
The authors thank Ms. Prosperidad Amargo for her excellent technical assistance.
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