Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies

Abstract

-Background -Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. Aim -To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. Methods -One hundred and fi fty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one examination were analyzed and their histological and Yamada classifi cation, as well as their location, size, histopathological fi ndings and treatment studied. All patients had at least one gastric polyp, as confi rmed by histological examination. Results -The polyps were classifi ed as hyperplastic, adenomatous and fundic gland polyps. The most of them measure less than 1 cm (hyperplastic polyps -60,5%; adenomatous polyps -73,6%; fundic gland polyps -72%). Hyperplastic polyps were the most frequent and accounted for 71.3% of the cases, whereas fundic gland polyps accounted for 16.3% and adenomatous polyps for 12.4%. Hyperplastic and adenomatous polyps were primarily single, whereas fundic gland polyps tended to be multiple. A carcinoma was detected in one hyperplastic polyp (0.9%) and in two adenomatous polyps (10.5%). High grade dysplastic foci were found in four adenomatous polyps (21%). Conclusions -The digestive endoscopy is the safest and effi cient method for the diagnosis of the gastric polyps, that in most of the patients does not show characteristic symptoms. The histopathological defi nition is not possible to the endoscopic glance being needed the pathologist's aid, once the conduct to be adopted will depend on the result of the biopsy.

Orta Anadolu bölgesinde gastrik polip prevalansı ve histopatolojik durumları

“…The frequency and most common type of gastric polyp vary widely depending upon the population studied. Hyperplastic polyps and adenomas are relatively more frequent than fundic gland polyps in regions where H. pylori infection is common (2,9). Although the prevalence of gastric polyps was lower in our study (0.59%) than in other studies (1), the ratio of premalignant and malignant type polyps was quite high (22%).…”

“…Archimandritis et al (2) from Greece reported that the majority of polyps (75%) were hyperplastic, while noninvasive intraepithelial neoplasias, also called adenomas, were found in approximately 7% of patients. Similarly, in a study from Brazil, gastric polyps were found in 0.6% of 26,000 endoscopies (9). About 70% of gastric polyps were hyperplastic, while 12% were noninvasive intramucosal neoplasias (adenomas), and 16% were fundic gland polyps.…”

Evaluation of gastric polyps detected by endoscopy: A single-center study of a four-year experience in Turkey

“…In countries in which Helicobacter pylori infections are commonly seen, hyperplastic and adenomatous polyps are found to be more frequent than fundic gland polyps (8,9). In western countries, where H. pylori infections are less common and proton pump inhibitor (PPI) drug use is more common, fundic gland polyps are seen more frequently (10,11).…”

Immunohistochemical and Molecular Features of Gastric Hyperplastic Polyps

“…1,2 Together with fundic gland polyps, these lesions account for approximately 80% of all gastric polyps. 1 Most gastric hyperplastic polyps show regenerative epithelial changes, characterized by architecturally distorted, cystically dilated glands lined by foveolartype epithelial cells, elongated pits and edematous inflamed lamina propria. Lesional epithelial cells may contain voluminous mucinous cytoplasm or show mucin depletion, but cytologic atypia is minimal or mild.…”

“…Twenty percent of affected patients have multiple polyps, especially those with autoimmune gastritis. 1,4 These lesions have been traditionally considered to be post-inflammatory regenerative polyps due to their frequent association with mucosal inflammation: 85% are associated with some type of gastric injury, including autoimmune gastritis, Helicobacter pylori (H. pylori) infection, prior surgical anastomosis, and chemical gastropathy. 4 Approximately one-third of hyperplastic polyps measure 1cm or more in diameter, and some contain foci of dysplasia or carcinoma.…”