High-grade dysplasia associated with fundic gland polyposis in a familial adenomatous polyposis patient, with special reference to APC mutation profiles.
We report a patient with familial adenomatous polyposis who developed high-grade dysplasia against a background of fundic gland polyposis. Two large high-grade dysplasia lesions were found in the gastric body, where numerous fundic gland polyps were present. In both lesions, the dysplastic epithelium covered non-neoplastic oxyntic glands that occasionally exhibit cystic changes. A genetic analysis for APC (adenomatous polyposis coli) revealed a somatic 50-bp deletion involving codons 1502-1517 and 2-bp deletion at codon 1465 in each lesion of high-grade dysplasia. In contrast, six of the 18 fundic gland polyps were found to harbor an identical mutation: 1-bp insertion at codon 1556. Both lesions of high-grade dysplasia and the fundic gland polyps were similarly located in the fundic gland area and were caused by the inactivation of APC; however, their mutation profiles of APC were different. These results imply that fundic gland polyps and high-grade dysplasia of the stomach have distinct preferences for APC genotypes in their development.
Sekine
Shigeki
S
Pathology Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan.
Shimoda
Tadakazu
T
Nimura
Satoshi
S
Nakanishi
Yukihiro
Y
Akasu
Takayuki
T
Katai
Hitoshi
H
Gotoda
Takuji
T
Shibata
Tatsuhiro
T
Sakamoto
Michiie
M
Hirohashi
Setsuo
S
D011125:Adenomatous Polyposis Coli / Q000235:genetics* / Q000473:pathology*; D000328:Adult; D001483:Base Sequence; D005748:Gastric Fundus / Q000473:pathology*; D017491:Genes, APC; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D011127:Polyps / Q000235:genetics / Q000473:pathology*