Carcinoma in gastric hyperplastic polyps

Zea-Iriarte, Walter-Leopoldo; Sekine, Ichiro; Itsuno, Minoru; Makiyama, Kazuya; Naito, Shinji; Nakayama, Toshiyuki; Nishisawa-Takano, Juan-Eiki; Hattori, Takanori

doi:10.1007/bf02093832

Cited by 90 publications

(69 citation statements)

References 27 publications

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“…The reported frequencies of dysplastic foci within hyperplastic polyps showed a wide range (4-22 %) [18,19] . Hizawa [20] and Zea-Iriarte [21] found the incidence of malignancy in hyperplastic polyps was 2 % and 1.8 %, respectively. Since hyperplastic polyps were usually associated with chronic gastritis, particularly autoimmune gastritis and H pylori gastritis, patients with hyperplastic polyp had an increased risk of synchronous or metachronous adenocarcinomas elsewhere in the stomach [2,4,22] .…”

Section: Discussionmentioning

confidence: 97%

Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

Gençosmanoğlu

Sen-Oran²,

Kurtkaya-Yapıcıer³

et al. 2003

WJG

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AIM:To analyze gastric polypoid lesions in our patientpopulation with respect to histopathologic features and demographic, clinical, and endoscopic characteristics of patients. METHODS:Clinical records and histopathologic reports of patients with gastric polypoid lesions were analyzed retrospectively. All lesions had been totally removed by either endoscopic polypectomy or hot biopsy forceps. The histopathologic slides were re-evaluated by the same histopathologist. RESULTS:One-hundred and fifty gastric polypoid lesions were identified in 91 patients. There were 53 (58 %) women and 38 (42 %) men with a median age of 53 (range, 31 to 82) years. The most frequent presenting symptom was dyspepsia that was observed in 35 (38.5 %) patients. Symptoms were mostly related to various associated gastric abnormalities such as chronic gastritis or H pylori infection rather than polypoid lesion itself. Polypoid lesions were commonly located in the antrum followed by cardia. Out of 150 lesions, 80 (53 %) had the largest dimensions less than or equal to 5 mm and only 7 were pedunculated. The frequencies of hyperplastic polyps, foveolar hyperplasia, and fundic gland polyps were 46 %, 18 %, and 14 % respectively. We also detected gastritis varioliformis in 12 specimens, lymphoid follicles in 9, 4 adenomatous polyps in 4, polypoid lesions with edematous mucosa in 4, inflammatory polyps in 3, and carcinoid tumor in 1. Adenomatous changes were observed within two hyperplastic polyps and low grade dysplasia in one adenoma. Histopathologic evaluation of the surrounding gastric mucosa demonstrated chronic gastritis in 72 (79 %) patients and H pylori infection in 45 (49 %).

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Section: Discussionmentioning

confidence: 97%

Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

Gençosmanoğlu

Sen-Oran²,

Kurtkaya-Yapıcıer³

et al. 2003

WJG

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“…Likewise, the majority of polyps in our study (83.9%) was hyperplastic. Although hyperplastic polyps are considered to be benign lesions, the potential of these polyps to undergo dysplastic and malignant changes has been reported (17-19); 0.5%-8.6% of all hyperplastic polyps are reported to be malignant (17,(19)(20)(21)(22)(23)(24)(25)(26). Carmack et al (10) reported that 5 (0.4%) of 1127 hyperplastic polyps showed low-grade dysplasia, while none of the polyps showed high-grade dysplasia.…”

Section: Discussionmentioning

confidence: 99%

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

Atalay

Solakoğlu²,

Sarı³

et al. 2020

Turk J Gastroenterol

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Background/Aims: The aim of this study was to evaluate the gastric polyps detected by endoscopy in our institution with respect to their frequency, size, anatomic location, presence of dysplasia, and histopathologic features. Materials and Methods: Records of a total of 14,240 patients who underwent endoscopy between January 2008 and January 2012 were reviewed retrospectively. Of the 14,240 patients, 174 determined to have at least 1 histopathologically proven polyp were included in the study. Results: Three hundred eleven gastric polyps were found in 174/14,240 (1.2%) patients (1.79 polyps per patient). Gastric polyps were found most commonly in the antrum (41.5%). Of all gastric polyps, 189 (60.8%) were less than 1 cm. Histopathologically, the most common polyp type was hyperplastic (n: 261, 83.9%), followed by adenomatous (n: 23, 7.4%). Eight (34.8%) of the adenomatous polyps showed dysplasia, and in 4 (17.4%) of these cases, the dysplasia was high-grade. Nineteen (6.1%) of all gastric polyps were identified to be fundic gland polyps. Conclusion: According to this study from Turkey, the majority of polyps detected by endoscopy was solitary, smaller than 1 cm, and found in the antrum; furthermore, the most common type was a hyperplastic polyp.

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“…4,[16][17][18] Data from several studies including our own suggest that dysplasia is more common in larger hyperplastic polyps. 19,20 The mechanisms by which dysplasia develops in gastric hyperplastic polyps may be similar to other epithelial neoplasms of the gastrointestinal tract. Hypermethylated promoter regions of mismatch repair genes such as MLH1 and MGMT have been reported in up to 10% of gastric adenomas, although MSI-H is less frequently identified in 3% of cases.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical and Molecular Features of Gastric Hyperplastic Polyps

Yantiss¹

2017

ACP

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Context: Gastric hyperplastic polyps are generally considered to be inflammatory lesions that develop in association with gastritis. Large polyps may contain foci of dysplasia, suggesting that they represent neoplasms, although molecular data regarding their pathogenesis are lacking.Objective: To describe the clinical, pathologic, and molecular features of large (>1cm) gastric hyperplastic polyps and compare them to those of small (≤1cm) hyperplastic polyps and gastric adenomas.Design: 15 large hyperplastic polyps (>1cm), including 4 with dysplastic foci, 10 small hyperplastic polyps (≤1cm), and 9 gastric adenomas were evaluated for immunohistochemical expression of MGMT, MLH-1, β-catenin, p27, p16, and p53. Polyps with dysplasia or abnormal β-catenin expression were assessed for APC and β-catenin (CTNNB1) mutations. Large hyperplastic polyps and adenomas were analyzed for KRAS and BRAF mutations. Results:Complete loss of MGMT expression was significantly more frequent in large hyperplastic polyps (47%), often in combination with loss of p27 (47%), compared to adenomas (0% and 0%, p=0.02, respectively) and smaller lesions [0% (p=0.02) and 10% (p=0.09), respectively]. All non-dysplastic hyperplastic polyps showed preserved MLH1 and lacked nuclear β-catenin staining, but 3 with dysplasia had APC or β-catenin mutations. KRAS or BRAF mutations were detected in 20% of large hyperplastic polyps and 11% of adenomas. Most polyps were entirely negative for p16, although 6 (40%) large hyperplastic polyps and 3 (33%) adenomas showed expression in <10% of the epithelium. None of the polyps showed >10% p53 expression in the epithelium. Conclusion:Small gastric hyperplastic polyps are likely non-neoplastic, reparative lesions, but large polyps often show immunohistochemical and molecular abnormalities such as concomitant loss of MGMT with p27 staining, APC or β-catenin mutations in areas of dysplasia, and KRAS or BRAF mutations. These findings raise the possibility that some large hyperplastic polyps of the gastric mucosa represent early neoplasms.

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Carcinoma in gastric hyperplastic polyps

Cited by 90 publications

References 27 publications

Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

Gastric polypoid lesions: Analysis of 150 endoscopic polypectomy specimens from 91 patients

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

Immunohistochemical and Molecular Features of Gastric Hyperplastic Polyps

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