Gastric Cancer

, Volume 21, Issue 6, pp 1058–1063 | Cite as

First report of an Asian family with gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) revealed with the germline mutation of the APC exon 1B promoter region

  • Yasuhiro Mitsui
  • Reiko Yokoyama
  • Shota Fujimoto
  • Kaizo Kagemoto
  • Shinji Kitamura
  • Koichi Okamoto
  • Naoki Muguruma
  • Yoshimi Bando
  • Hidetaka Eguchi
  • Yasushi Okazaki
  • Hideyuki Ishida
  • Tetsuji TakayamaEmail author
Case Report


A 48-year-old Japanese female with left hypochondralgia presented at our hospital. Esophagogastroduodenoscopy (EGD) revealed gastric cancers and carpeting fundic gland polyposis (FGPs) without Helicobacter pylori infection. Computed tomography showed multiple liver metastases. Total colonoscopy revealed a colonic tubular adenoma but not polyposis. She was diagnosed as having advanced gastric cancer with liver metastasis and received chemotherapy. Her mother had died from gastric cancer, and her elderly brother and niece had FGPs as revealed by EGD. Thus, the pedigree was diagnosed as gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). Germline mutation analysis exhibited a point mutation in exon1B of the APC gene (c.-191T > C). Adenocarcinoma showed a gastric mucinous phenotype and was positive for a somatic mutation of p53, suggesting that p53 mutation may play a role in FGPs carcinogenesis. This is the first family with GAPPS in Asia in whom germline mutation of APC exon 1B has been detected.


GAPPS APC gene Exon1B 



We thank Misato Hirata for her assistance with sample preparation of genomic DNA from biopsied specimens.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee and with the Helsinki Declaration. Informed consent to be included in the study was obtained from all patients.


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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  • Yasuhiro Mitsui
    • 1
  • Reiko Yokoyama
    • 1
  • Shota Fujimoto
    • 1
  • Kaizo Kagemoto
    • 1
  • Shinji Kitamura
    • 1
  • Koichi Okamoto
    • 1
  • Naoki Muguruma
    • 1
  • Yoshimi Bando
    • 2
  • Hidetaka Eguchi
    • 3
  • Yasushi Okazaki
    • 3
  • Hideyuki Ishida
    • 4
  • Tetsuji Takayama
    • 1
    Email author
  1. 1.Department of Gastroenterology and OncologyTokushima University Graduate School of Biomedical SciencesTokushima cityJapan
  2. 2.Division of PathologyTokushima University HospitalTokushima cityJapan
  3. 3.Intractable Disease Research CenterGraduate School of Medicine, Juntendo UniversityTokyoJapan
  4. 4.Department of Digestive Tract and General SurgerySaitama Medical Center, Saitama Medical UniversityKawagoe cityJapan

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