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Invited Lecture International Session
(Symposium) International Session
(Workshop) Symposium Workshop International Poster Session
International Session（Symposium）8(JGES・JSGE・JSGS・JSGCS)
Sat. November 23rd   14:30 - 17:00   Room 11: Portopia Hotel South Wing Topaz
IS-S8-3_E
 Capsule endoscopy for small intestinal surveillance in patients with familial adenomatous polyposis
Yasushi Sato1, Hideki Ishikawa2, Tetsuji Takayama3
1Department of Community Medicine for Gastroenterology and Oncology, Tokushima University, 2Kyoto Prefectural University of Medicine, 3Department of Gastroenterology and Oncology, Tokushima University
【Purpose】Familial adenomatous polyposis (FAP) causes adenoma-related polyps in the small intestine, but its prevalence, clinical significance, and genotype-phenotype correlation with respect to small intestinal polyps (SIP) are unclear. We performed small intestinal capsule endoscopy (CE) to investigate the characteristics of SIP and the relationship between SIP and germline adenomatous polyposis coli (APC) gene mutations.
【Method】Overall, 168 FAP patients from 120 families (M/F, 83/85; average age, 42.3 years) underwent CE. Endoscopic and histological findings of polyps were also evaluated by double balloon endoscopy. Furthermore, we analyzed germline APC mutations.
【Result】CE detected SIP in 141/158 patients (89.2%; size range 1–35 mm; mean number of polyps, 64.6). SIP occurred predominantly in the jejunum and frequent CE findings were white point-formed microlesion (45.3%) and white flat lesion (16.4%). Pathologically, most of the lesions were low grade adenomas. The prevalence of SIP correlated with the Spigelman stage. In patients with germline APC gene mutation (82/105, 78.1%), the prevalence of SIP tended to be higher in patients with mutations in Armadillo repeat and 15-amino acid repeat regions.
【Conclusion】Our results indicated that the prevalence of SIP was relatively high in patients examined by CE and most of the lesions were low grade adenomas. There also seems to be a genotype-SIP phenotype correlation in FAP.
Index Term 1: familial adenomatous polyposis
Index Term 2: small intestinal
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