Although numerous patients do not harbor CDH1 mutations, single allele expression is downregulated, which plays an important role in cell polarity and adhesion.13 Further, recent studies show that a CTNNA1 lineage mutation is the genetic cause of the disease.14 The main clinical methods for treating familial gastric cancer (FIGC) are prophylactic gastrectomy and endoscopy, although potential therapeutic drugs remain to be developed.15 Gastric adenocarcinoma and proximal polyposis of the stomach (Gapps) is incompletely characterized, and some carriers may have normal endoscopy findings. This evidence concerns the gene CDH1 and Familial gastric cancer.