Gastric polyps diagnosed by double-contrast upper gastrointestinal barium X-ray radiography mostly arise from the Helicobacter pylori-negative stomach with low risk of gastric cancer in Japan

Abstract

Background Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is a method broadly used for gastric cancer screening in Japan. Gastric polyp is one of the most frequent findings detected by UGI-XR, but how to handle it remains controversial. Methods Gastric polyps of the 17,264 generally healthy subjects in Japan who underwent UGI-XR or upper gastrointestinal endoscopy (UGI-ES) in 2010 were analyzed. Results Of the 6,433 UGI-XR examinees (3,405 men and 3,028 women, 47.4 ± 9.0 years old), gastric polyps were detected in 464 men (13.6 %) and 733 women (24.2 %) and were predominantly developed on the non-atrophic gastric mucosa (p \ 0.0001). Multiple logistic regression analysis showed that the presence of gastric polyps has significant association with lower value of serum antiHelicobacter pylori IgG titer, female gender, lighter smoking habit, older age, and normal range of body mass index ( ‡18.5 and \25), but not with drinking or serum pepsinogen I/II ratio. During the 3-year follow-up, gastric cancer occurred in 7 subjects (0.11 %), but none of them had gastric polyps at the beginning of the follow-up period. Of the 2,722 subjects with gastric polyps among the 10,831 UGI-ES examinees in the same period, 2,446 (89.9 %) had fundic, 267 (9.8 %) had hyperplastic, and 9 (0.3 %) had adenomatous/cancerous polyps. Conclusions Gastric polyps diagnosed by UGI-XR predominantly arise on the Helicobacter pylori-negative gastric mucosa with a low risk of gastric cancer in Japan. In the prospective observation, none of the UGI-XR examinees with gastric polyps developed gastric cancer for at least 3 years subsequently.

Gastric hyperplastic polyps inversely associated with current Helicobacter�pylori infection

“…These conflicting results may be attributed to the differences in ethnicity or differences in the prevalence of H. pylori (18,19). In agreement with other studies, older age appeared to be associated with an increased risk for HPs (6,7,20).…”

Preliminary opinion on assessment categories of stomach ultrasound report and data system (Su-RADS)

“…The most important reason that TUS-OCCA is currently performed and continues to be investigated is that the pathological regression of various gastric lesions has become better understood during the recent 5 years, as follows: (1) the majority of gastric polyps is benign and thought to be of no malignant potential; and [20, 21] (2) precancerous gastric lesions are usually gastric mucosa with intestinal metaplasia or dysplasia, which presents as hypoechoic mucosal thickening [22–24]. The detection rate of TUS-OCCA for gastric polyps, which usually need no further mandatory treatment, is very low (approximately 20%), and the detection rate for hypoechoic thickening of the gastric wall, which does require further treatment, is high.…”

Use of immunotherapy in the treatment of gastric cancer (Review)

“…In China, it has been estimated that there were 67,910 new cases of GC and 49,800 GC-associated mortalities in 2015 (2); therefore, GC is one of the most common types of cancer ranking second following lung cancer in terms of morbidity and mortality, and the 5-year survival rate of GC is only 28% (2). As the majority of patients with GC are primarily diagnosed at the advanced stages of disease, the potential for successful treatment is limited to a few patients where early detection and comprehensive treatment were achieved (3,4). Even with use of combination chemotherapy, consisting of platinum and 5-fluorouracil (5-FU), only a modest survival advantage is obtained for patients with advanced GC (5–8).…”