Clinicopathological and molecular pathological differentiation between fundic gland polyp and fundic gland polyp-like lesion of the stomach

• Project/Area Number: 17K08692
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Human pathology
• Research Institution: Shiga University of Medical Science
• Principal Investigator: Kshima Ryoji 滋賀医科大学, 医学部, 教授 (40252382)
• Co-Investigator(Kenkyū-buntansha): 福田 昌英 大分大学, 医学部, 医員 (80854299) ; 向所 賢一 滋賀医科大学, 医学部, 准教授 (50343223) ; 松原 亜季子 滋賀医科大学, 医学部, 助教 (80626325) ; 石垣 宏仁 滋賀医科大学, 医学部, 助教 (90432301)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: fundic gland polyps / foveolar cell / parietal cell protrusion / PPIs / 胃底腺ポリープ / プロトンポンプ阻害薬 / 胃底腺ポリープ様病変 / 消化器 / 胃 / ヘリコバクター・ピロリ菌

Outline of Final Research Achievements

Our study showed that hyperplastic foveolar cells and parietal cells in fundic gland polyps were significantly more frequent with PPI treatment than without PPI treatment. Furthermore, multiplex immunohistochemical stains showed the double-positive cell ratio of MUC5AC, a marker of foveolar epithelium, and Ki67 the in the deep mucosal layers of FGPs were significantly higher with PPI treatment than without PPI treatment. In the gene analysis, b-catenin gene mutations were found in only 9.7% of FGPs with PPI treatment.Enlargement of fundic gland cysts due to parietal cell protrusion and foveolar cell hyperplasia, especially in the deep layer of fundic glands, may promote the enlargement of FGPs in patients on PPIs.

Academic Significance and Societal Importance of the Research Achievements

プロトンポンプ阻害薬で増大する胃底腺ポリープの増大のメカニズムの一部を明らかにすることが出来た。近年、腫瘍性異型を伴った胃底腺ポリープや出血を伴った胃底腺ポリープの報告も増えており、これらのポリープ発生、制御に役立つ新たな知見であるかもしれない。

Research Products

• [Journal Article] Histological analysis of fundic gland polyps enlarged by proton pump inhibitors (2019)
  • Author(s): Fukuda M, Ishigaki H, Sugimoto M, Mukaisho K, Matsubara A, Ishida H, Moritani S, Itoh Y, Sugihara H, Andoh A, Ogasawara K, Murakami K, Kushima R
  • Journal Title: Histopathology Volume: 75 Issue: 4 Pages: 537-545
  • DOI: 10.1111/his.13902
  • Peer Reviewed
• [Journal Article] No transformation of a fundic gland polyp with dysplasia into invasive carcinoma after 14 years of follow-up in a proton pump inhibitor-treated patient: A case report (2018)
  • Author(s): Fukuda Masahide、Ishigaki Hirohito、Ban Hiromitsu、Sugimoto Mitsushige、Tanaka Eri、Yonemaru Junpei、Kuroe Shinobu、Namura Tomo、Matsubara Akiko、Moritani Suzuko、Murakami Kazunari、Andoh Akira、Kushima Ryoji
  • Journal Title: Pathology International Volume: 68 Issue: 12 Pages: 706-711
  • DOI: 10.1111/pin.12739
  • Peer Reviewed / Open Access
• [Presentation] プロトンポンプ阻害薬内服患者における胃底腺ポリープの組織学的特徴とポリープ増大因子の検討. (2019)
  • Author(s): 福田昌英、石垣宏仁、松原亜季子、森谷鈴子、向所賢一、杉原洋行、伊藤靖、小笠原一誠、村上和成、九嶋亮治.
  • Organizer: 日本病理学会総会
• [Presentation] The morphological changes of fundic gland polyps after PPI therapy. (2019)
  • Author(s): Fukuda M, Ishigaki H, Sugimot M, Mizukami K, Ueo T, Abe H, Andoh A, Kushima R, Murakami K
  • Organizer: ACG 2019・第84回米国消化器病学会議
• [Presentation] プロトンポンプ阻害薬内服患者における胃底腺ポリープの組織学的特徴とポリープ増大因子の検討 (2019)
  • Author(s): 福田昌英、九嶋亮治ほか
  • Organizer: 第108回日本病理学会総会
• [Book] 胃炎の京都分類 第2章4-3 PPI関連胃症の病理学的所見 (2018)
  • Author(s): 福田昌英、九嶋亮治
  • Total Pages: 158
  • Publisher: 日本メディカルセンター
  • ISBN: 9784888753098