Gastric Xanthoma Is Associated With Gastric Cancer, Precancerous Lesions

Gastric xanthomas are associated with the development of gastric cancer and precancerous lesions, according to study results published in the Journal of Digestive Diseases.

Researchers reviewed medical records of patients who underwent upper gastrointestinal (GI) endoscopy. Individuals with chronic gastritis, intestinal metaplasia, or gastric cancer were included in the study. Those with ulcers, esophageal or duodenal cancer, nonepithelial tumors in the stomach, or who had recent injury of the GI tract or any dissection or gastrectomy were excluded from the study.

To assess the detection rate of gastric xanthoma, patients were stratified according to gastropic and/or histopathological findings: those with chronic gastritis, the precancerous lesion group, and the gastric cancer group. Additionally, patients were grouped according to their age (<50 years and ≥50 years).

A total of 47,736 cases were included in the final study, with 42,758 patients in the chronic gastritis group, 3672 in the precancerous lesion group, and 1306 in the gastric cancer group.

Gastric xanthoma was observed in 1360 cases (2.85%), with 844 (62.06%) having a single lesion and 516 (37.94) having multiple lesions. Detection was more likely to occur in the gastric antrum (n=714, 52.50%), in more men than women (3.26% vs 2.40%, P <.001), and in those aged 50 years and older (3.95% vs 1.64%, P <.001).

The detection rate of gastric cancer was highest in the group with precancerous lesions (n=308, 8.39%, P =.001), although the gastric cancer group had a lower rate than the chronic gastritis group (n=71, 5.44% and n=981, 2.29%, P =.001, respectively).

Of note, multivariate analysis found gastric xanthoma to be associated with a higher risk for precancerous lesions (OR, 3.197, 95% CI 2.791-3.662, P <.001) and gastric cancer (OR, 1.794, 95% CI 1.394-2.309, P <.001).

Study limitations include the possibility of missing gastric xanthoma lesions and inability to generalize the findings due to the single-center design.

“To prevent the development of gastric cancer and precancerous lesions, physicians should pay more attention to patients with GX,” study authors noted. “If GX is identified by endoscopy, mucosal changes, in particular precancerous lesions, needs to be carefully observed, and close follow-up is required even if no gastric cancer is found.”