Gastric polyps and polypoid lesions: Retrospective analysis of 36650 endoscopic procedures in 29940 patients

Abstract

Background/Aims: The frequency of gastric polyps increases with the widespread use of endoscopy for diagnosis and treatment. As gastric polyps can be malignant or premalignant, histopathological evaluation is needed. The aim of this study is to determine the prevalence and characteristics of gastric polyps in patients undergoing endoscopy. Materials and Methods: This study consisted of a retrospective analysis of 36650 consecutive endoscopy and associated pathology reports of 29940 patients between December 2005 and February 2012 in a tertiary-referral center. Results: Gastric polypoid lesions were detected in 666 (2.22%) patients. Hyperplastic polyps were the most common type of polyps (36.2%), followed by fundic gland polyps (8.3%), inflammatory fibroid polyps (2.4%) and adenomatous polyps (1.9%). Foveolar hyperplasia, neuroendocrine tumor, xanthoma, gastrointestinal stromal tumor, adenocarcinoma and lymphoma were less commonly seen. Malignant transformation was seen in 0.42% of hyperplastic polyps and in 23.1% of adenomatous polyps. Conclusion: Endoscopic appearance of gastric polyps can be variable, distinguishing macroscopically can be misleading. Because of their malignant potential histopathological evaluation is mandatory and polypectomy should be performed whenever possible.

Presence of Fundic Gland Polyps in Patients Undergoing Upper Gastrointestinal Endoscopy: Incidence and the Relation with the Use of Proton Pump Inhibitors

“…adenomatous polyps (1.9%). Malignant transformation was seen in 0.42% of hyperplastic polyps and in 23.1% of adenomatous polyps [4]. Changes of the appearance of the gastric mucosa are described in PPI users.…”

Endoscopic Resection Versus Surgical Resection for Gastric Neuroendocrine Neoplasms Without Distant Metastasis

“…Recent epidemiologic evidence suggests that the incidence of g-NENs is between 0.3% to 1.8% of all gastric tumors [20,21]. Studies from national histopathology or endoscopy database have shown that the prevalence of g-NENs ranks in the top 5 among the gastric polypoid lesions, and about 3.3% of gastric polypoid lesions are neuroendocrine tumors (NETs) [22,23]. Therefore, it is important to enhance the understanding of g-NENs.…”

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

“…It has been found patients taking PPI for less than 1 year will not develop FGP [29] ; however, long-term PPI therapy increases the risk of polyps (in particular, it is associated with a 4-fold increased risk for FGP) [30] . This phenomenon is considered to be a cystic change caused by the chronic stimulation of gastric mucosa by a high level of gastrin [31] . Animal experiments have revealed that gastrin can promote the growth of parietal cells by increasing their height and size [32] .…”