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. 2021 Apr 1;13(7):1657.
doi: 10.3390/cancers13071657.

Upper Gastrointestinal Lesions during Endoscopy Surveillance in Patients with Lynch Syndrome: A Multicentre Cohort Study

Romain Chautard  1 , David Malka  2 , Elia Samaha  3 , David Tougeron  4 , Didier Barbereau  1 , Olivier Caron  2 , Gabriel Rahmi  3 , Thierry Barrioz  4 , Christophe Cellier  3 , Sandrine Feau  1 , Thierry Lecomte  1
Affiliations

Upper Gastrointestinal Lesions during Endoscopy Surveillance in Patients with Lynch Syndrome: A Multicentre Cohort Study

Romain Chautard et al. Cancers (Basel). .

Abstract

Background: Patients with Lynch syndrome are at increased risk of gastric and duodenal cancer. Upper gastrointestinal endoscopy surveillance is generally proposed, even though little data are available on upper gastrointestinal endoscopy in these patients. The aim of this retrospective study was to evaluate the prevalence and incidence of gastrointestinal lesions following upper gastrointestinal endoscopy examination in Lynch patients.

Methods: A large, multicentre cohort of 172 patients with a proven germline mutation in one of the mismatch repair genes and at least one documented upper gastrointestinal endoscopy screening was assessed. Detailed information was collected on upper gastrointestinal endoscopy findings and the outcome of endoscopic follow-up.

Results: Seventy neoplastic gastrointestinal lesions were diagnosed in 45 patients (26%) out of the 172 patients included. The median age at diagnosis of upper gastrointestinal lesions was 54 years. The prevalence of cancer at initial upper gastrointestinal endoscopy was 5% and the prevalence of precancerous lesions was 12%. Upper gastrointestinal lesions were more frequent after 40 years of age (p < 0.001). Helicobacter pylori infection was associated with an increased prevalence of gastric, but not duodenal, lesions (p < 0.001).

Conclusions: Neoplastic upper gastrointestinal lesions are frequent in patients with Lynch syndrome, especially in those over 40 years of age. The results of our study suggest that Lynch patients should be considered for upper gastrointestinal endoscopic and Helicobacter pylori screening.

Keywords: Helicobacter pylori; Lynch syndrome; duodenal cancer; gastric cancer; screening; upper gastrointestinal endoscopy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence of gastric precancerous lesions and cancer by age group.
Figure 2
Figure 2
Prevalence of precancerous lesions and cancer in carriers of the MHL1, MSH2, and MSH6 mutations.
See this image and copyright information in PMC

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