Pathophysiological and clinical aspects of gastric hyperplastic polyps

Abstract

Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori (H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.

A Clinico-Pathological Study of Gastric Polyps and Their Relationship with Helicobacter Pylori Infection atthe Pathology Departments of Hospitals in Yazd from 2011 To 2016

“…Most polyps in their study were fundus gland polyps (FGPs) and polyps and gender were therefore found to be related; but in the present study, despite the higher prevalence of the female patients, no significant relationship were observed between polyps and gender. The disparity between these two studies may be due to the small sample size used in the present study [8].Most polyps in the present study were in the body of the stomach, which is consistent with the results obtained by Markowski et al, although researchers used to argue that most gastric polyps develop in the antral region [8,9] The most frequent age group affected in this study was the over-60 age group, which is inconsistent with the results obtained by Fan N-N et al . (2015) who had found the 45 to 60 age group to be most affected by polyps and had reported the incidence of gastric polyps to reduce after age 60; in the present study, however, the incidence of polyps increased with age [7].…”

“…Hyperplastic polyps can DOI: 10.9790/0853-1603018790 www.iosrjournals.org 89 | Page be singular or multiple and can present independently of other conditions or concomitant with familial polyposis syndrome [6,7]. In the present study, hyperplastic polyps made up 69.3% of all the reported gastric polyps, which agrees with the results obtained by Markowski AR et al, who reported that, although most gastric polyps in the US are of the fundus type, 25% to 71% of the polyps found in their study were hyperplastic [9]. The incidence of hyperplastic polyps increases with age and they are mostly observed in people over 65 [1,4].…”

“…A review of literature shows that, hyperplastic polyps were the most common type of polyp concomitant with H. pylori infection [3,4,6] In line with other studies, most polyps had no concomitant pathologies in the present study. In a study conducted by Markowski AR et al on the clinical symptoms of polyps, most polyps were found to be asymptomatic and were detected incidentally, also in the present study, the most frequent clinical symptom reported was abdominal pain [9]. The disparity between the results of the present study and other studies may be attributed to the time factor, i.e.…”

“…Most gastric polyps are detected incidentally in endoscopic examinations performed for other reasons and are mostly asymptomatic. In the endoscopic view, some polyps are in plaque form, others are in a nodular or lobular form and a few are attached without a stalk [7,9]. Most patients examined in the present study had presented with clinical symptoms such as abdominal pain, vomiting, dysphagia, diarrhea and reflux, which is inconsistent with the results of similar studies.…”

“…The disparity between the results of the present study and other studies may be attributed to the time factor, i.e. the duration of time since the development of the polyp, as most polyps begin to show clinical symptoms a long time after their incidence, while in hospitals that offer endoscopy services, polyps are detected when they are smaller and still asymptomatic [8,9]. In the present study, the age group mostly infected with H. pylori was the 45 to 60 age group.…”