Abstract
Lynch syndrome (LS) increases the risk of numerous different cancers including gastric cancer. While some current guidelines recommend empiric gastric biopsies be performed during upper gastrointestinal cancer surveillance in Lynch syndrome (LS), the yield of these biopsies and the prevalence of gastric intestinal metaplasia (GIM) and Helicobacter pylori (HP) in LS remains unknown. Herein we analyze 165 consecutive individuals with LS who underwent upper endoscopic surveillance with biopsies of the gastric antrum and body being performed universally in all individuals. Of the study cohort, 6.7% of universally biopsied individuals with LS had GIM and/or HP (5.5% GIM, 3.6% HP). Biopsies of the gastric body did not increase rates of GIM/HP identification compared to antral biopsies alone. GIM was detected on subsequent surveillance in 2.2% of individuals without prior GIM, which may represent either newly developed GIM or GIM that was missed on a prior upper endoscopy due to sampling error. These findings support inclusion of at least baseline gastric antrum biopsies as a routine component of all standard surveillance upper endoscopies performed in LS.
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The Jason and Julie Borrelli Lynch Syndrome Research Fund (BWK) and the King Family Fund for Lynch Syndrome Education, Outreach and Impact (BWK).
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Conception and design (MP, BWK), collection and assembly of data (All authors), data analysis and interpretation (MP, BWK), initial manuscript writing (MP, BWK), manuscript review and editing (All authors), project oversight (BWK).
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Pulaski, M., Dungan, M., Weber, M. et al. Low prevalence of gastric intestinal metaplasia and Helicobacter pylori on surveillance upper endoscopy in Lynch syndrome. Familial Cancer 23, 23–27 (2024). https://doi.org/10.1007/s10689-023-00354-z
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DOI: https://doi.org/10.1007/s10689-023-00354-z