Gastric Polyps: A Retrospective Analysis Of 26,000 Digestive Endoscopies

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 fifty 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 classification, as well as their location, size, histopathological findings and treatment studied. All patients had at least one gastric polyp, as confirmed by histological examination. Results - The polyps were classified 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 efficient method for the diagnosis of the gastric polyps, that in most of the patients does not show characteristic symptoms. The histopathological definition 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.4411417Burt, R.W., Gastric fundic gland polyps (2003) Gastroenterology, 125, pp. 1462-1469Daibo, M., Itabashi, M., Hirota, T., Malignant transformation of gastric hyperplastic polyp (1987) Am J Gastroenterol, 82, pp. 1016-1025Deppish, L.M., Rona, V.T., Gastric epithelial polyps: A 10-year study (1989) J Clin Gastroenterol, 11, pp. 10-15Di Giulio, E., Lahner, E., Micheletti, A., Milione, M., D'Ambra, G., Bordi, C., Delle Fave, G., Annibale, B., Occurrence and risk factors for benign epithelial gastric polyps in atrophic body gastritis on diagnosis and follow-up (2005) Aliment Pharmacol Ther, 21, pp. 567-567Ginsberg, G.G., Firas, H.A.K., Fleischer, D.E., Reilly, H.F., Benjamin, S.B., Gastric polyps: Relationship of size and histology to cancer risk (1995) Am J Gastroenterol, 91, pp. 714-717Hattori, T., Morphological range of hyperplastic polyps of the stomach (1985) J Clin Pathol, 38, pp. 622-630Hnizdil, L., Piskac, P., Dvorak, M., Endoscopic gastric polypectomy - personal experience (2002) Rozhl Chir, 81, pp. 324-326Hughes, R., Gastric polyps and polypectomy: Rational, technique and complications (1984) Gastrointest Endosc, 30, pp. 101-102Macenlle-Garcia, R., Bassante-Flores, L.A., Fernandez-Seara, J., Gastric epithelial polyps. A retrospectrive study 1995-2000 (2003) Rev Clin Esp, 203, pp. 368-372Ming, S.C., Malignant potential of epithelial polyps of stomach (1984) Precursors of gastric cancer, p. 219. , Ming SC, editor, New York: Praeger;Muehldorfer, S.M., Stolte, M., Martus, P., Hahn, E.G., Ell, C., Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: A prospective multicentre study (2002) Gut, 50, pp. 465-470Nakamura, T., Nakano, G., Histopathological classification and malignant chance in gastric polyps (1985) J Clin Pathol, 38, pp. 754-764Oota K. Histological typing of gastric and oesophageal tumors. In: WHO, editor. International classification of tumors, 18. Genève: WHO1977. p.37Palacios-Salas, F., Frisancho-Velarde, O., Palomino-Portilla, E., Gastric polyps and histological changes in surrounding mucosa (2003) Rev Gastroenterol Peru, 23, pp. 245-253Randall, G.M., Endoscopic diagnosis of gastric neoplasm (1992) Gastrointest Endosc Clin North Am, 2, pp. 469-493Robbins, S.L., Tumors of the stomach (1995) Pathological basis of disease, p. 161. , Robbins SL, editor, Boston: W.B. Saunders;Seifert, E., Gail, K., Weismuller, J., Gastric polypectomy (1985) Endoscopy, 15, pp. 8-11Sivelli, R., Del Rio, P., Bonati, L., Sianesi, M., Gastric polyps: A clinical contribution (2002) Chir Ital, 54, pp. 37-40Snover, D., Benign epithelial polyps of the stomach (1985) Pathol Ann, 20 (PART I), pp. 303-329Yamada, T., Ichikawa, H., X-ray diagnosis of elevated lesions of the stomach (1974) Radiology, 110, pp. 79-8