Gastric Polyposis and Adenocarcinoma Mechanisms
Summary
Gastric polyposis encompasses a spectrum of polypoid lesions in the stomach that may precede or coexist with gastric adenocarcinoma. Syndromic forms such as gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) often arise from germline mutations in the promoter 1B region of the APC gene, leading to fundic gland polyps with variable dysplastic potential. Sporadic polyps, including hyperplastic and adenomatous subtypes, can progress through molecular events characterised by Wnt/β-catenin pathway activation, TP53 alterations and epigenetic modifications. The interplay of genetic susceptibility, chronic inflammation—often associated with Helicobacter pylori infection—and environmental influences such as diet and microbiome composition shapes the risk of malignant transformation. Endoscopic surveillance utilises advanced imaging and histopathological grading to stratify patients for polypectomy or prophylactic gastrectomy. Recent mechanistic insights have elucidated clonal evolution within polyps, revealing early subclonal diversification that may dictate therapeutic response. A deeper understanding of these pathways underpins global efforts to refine risk assessment, personalise surveillance intervals and develop targeted chemopreventive strategies.
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Gastric Polyposis and Adenocarcinoma Mechanisms publication trend
The graph below shows the total number of articles in gastric polyposis and adenocarcinoma mechanisms across all publications each year (not limited to Nature Index journals).
Technical terms
APC promoter 1B region: The regulatory segment of the adenomatous polyposis coli gene whose mutations are implicated in familial gastric polyposis syndromes.
Fundic gland polyps: Benign epithelial protrusions arising from glands in the gastric fundus, often seen in polyposis syndromes.
Dysplasia: The presence of abnormal cellular architecture indicating pre-neoplastic transformation.
Prophylactic gastrectomy: Preventive removal of the stomach to avert cancer development in genetically at-risk patients.
Penetrance: The proportion of individuals carrying a particular genetic variant who exhibit the associated disease phenotype.
References
- Four cases of gastric adenocarcinoma and proximal polyposis of the stomach treated by robotic total gastrectomy. Surgical Case Reports (2022).
- The comprehensive review of gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) from diagnosis and treatment. Annals of Gastroenterological Surgery (2023).
- Gastrointestinal manifestations in patients with gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS): a systematic review with analysis of individual patient data. Hereditary Cancer in Clinical Practice (2024).
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