Case-control analysis of fundic gland polyps and proton-pump inhibitors. A pathologist's perspective

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Introduction and aim: Adequately preserved slides and tissue blocks in pathology archives, when re-reviewed and associated with patient charts, are important tools to further assess prevalence changes and associations of certain pathologies. Our aim was to identify whether proton-pump inhibitor (PPI) use, dose, and duration of use were associated with gastric polyps and their phenotypes in a case-control study. Methods: The slides from patients with a morphologic diagnosis of either hyperplastic polyps or fundic gland polyps were retrieved from the 1980, 1990, 2000, 2010, and 2016 surgical pathology files at a tertiary care hospital in Mexico City and re-evaluated. Cases were paired by age and sex with patients that underwent endoscopy and gastric mucosa biopsy in the same year, with no evidence of polyps. Results: A total of 133 (3.8%) patients with gastric polyps were identified from 3,499 gastric biopsies taken in the abovementioned years and compared with 133 paired controls. Dyspepsia was more prevalent in the controls (p = 0.002) and abdominal pain was more prevalent in the patients with gastric polyps (p = 0.001). PPI use (OR 7.7, 95% confidence interval, 4.4-13.3) and taking more than one PPI medication (OR 4.9, 95% confidence interval, 1.09-22.3) were significantly associated with the presence of gastric polyps. The fundic gland phenotype in the oxyntic mucosa was more frequently associated with PPI use (p < 0.042), with a continuous increase in its prevalence starting in the year 2000 (p = 0.017 for trend). Conclusion: PPI administration for at least one year was associated with gastric fundic gland polyps.




Velazquez-Dohorn, M., López-Durand, C. F., Candanedo-González, F., Araujo-Villalvazo, E. A., & Gamboa-Domínguez, A. (2020). Case-control analysis of fundic gland polyps and proton-pump inhibitors. A pathologist’s perspective. Revista de Gastroenterologia de Mexico, 85(1), 42–47.

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