Dysplasia and dysregulation of proliferation in foveoral and surface epithelia of fundic gland polyps from patients with familial adenomatous polyposis

Tsung Teh Wu, Susan Kornacki, Asif Rashid, John H. Yardley, Stanley R. Hamilton

Research output: Contribution to journalArticle

123 Scopus citations

Abstract

Fundic gland polyps (FGPs) of the stomach are regarded as hamartomatous or hyperplastic/functional polyps that occur sporadically but at increased frequency in patients with familial adenomatous polyposis syndrome (FAP). There is controversy about the histopathology of FGPs, including occurrence of dysplasia. We, therefore, studied dysplasia in 270 sporadic FGPs from 216 patients and 49 FGPs from 24 patients with FAP. We evaluated dysregulation of epithelial proliferation manifested by loss of the normal inverse topographic distribution of Ki-67 proliferation marker and the cyclin-dependent kinase inhibitor p21(WAFI/CIPI) using immunohistochemistry in 27 sporadic FGPs and in 22 FGPs from patients with FAP. Dysplasia in foveolar and surface epithelia occurred in 12 of 49 (25%) FGPs in patients with FAP but in only 3 of 270 (1%) of sporadic FGPs (p ≤ 0.000001). Fourteen of 49 (29%) of FGPs from patients with FAP were indefinite for dysplasia, as contrasted with 8 of 270 (3%) sporadic FGPs (p ≤ 0.00001). The normal inverse topographic distribution of Ki-67 and p21(WAFI/CIPI) was maintained in 20 of 22 (91%) of FGPs negative for dysplasia but was lost in all (8 of 8) FGPs with dysplasia and in 11 of 19 (58%) FGPs that were indefinite for dysplasia (p = 0.00001). The results indicate that dysplasia can occur in foveolar and surface epithelia of FGPs, especially in patients with FAP, and often is preceded by dysregulation of epithelial proliferation when the morphologic abnormalities are indefinite for dysplasia.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalAmerican Journal of Surgical Pathology
Volume22
Issue number3
DOIs
StatePublished - Mar 24 1998

Keywords

  • Cyclin-dependent kinase inhibitor
  • Dysplasia
  • Familial adenomatous polyposis
  • Fundic gland polyp
  • Proliferation

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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