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Evaluation of gastric hyperplastic polyps and their precursor lesions

Year 2021, Volume: 20 Issue: 1, 3 - 7, 14.05.2021
https://doi.org/10.17941/agd.927776

Abstract

Background and Aims: Approximately 75-90% of gastric polyps are comprised of hyperplastic polyps formed by precursor lesions after foveolar hyperplasia and chronic gastritis due to excessive epithelial regeneration caused by chronic inflammation. In this study, we discuss the relationship between gastric hyperplastic polyps and precursor lesions and Helicobacter pylori as well as intestinal metaplasia and the atrophy states of these lesions in light of the literature. Material and Methods: Among 7,903 patients who underwent esophagogastroduodenoscopy
at Muş State Hospital between January 2016 and January 2020, 172 with an endoscopic view of polypoid structures were included and histopathologically examined. Data including age, sex, admission complaint, location of the polypoid lesion, and histopathological type were recorded. Results: The patients [101 females (58.8%); age, 49.4 ± 15 (19–83) years] underwent polypectomy. They were divided into the reactive polypoid group (57 patients with reactive foveolar hyperplasia and 53 with reactive chronic gastritis) and the actual polypoid group
(62 patients; hyperplastic polyps in 47). Polypoid lesions were most often localized in the antrum. The most common complaint on admission was dyspepsia. The diameter of the actual polypoid lesions was significantly larger than that of the reactive polypoid lesions (p < 0.05). The rate of Helicobacter pylori infection was significantly higher in the reactive polypoid group than in the actual polyploid group (p < 0.05). There was no difference in terms of intestinal metaplasia and atrophy (p > 0.05). Conclusions: No significant differences were observed in the prevalence of intestinal metaplasia and atrophy or between the rates of atrophy and intestinal metaplasia (precancerous condition of the hyperplastic polyps and their precursor lesions). Therefore, biopsy
or excision of endoscopically detected lesions should be performed to diagnose dysplasia. Patients should be treated for Helicobacter pylori.

References

  • 1. Şen Oran E, Gençosmanoğlu R. Midenin hiperplastik polipleri: Tanı, tedavi ve izlemde güncel yaklaşımlar. Güncel Gastroenteroloji 2003;7:127-35.
  • 2. Morais DJ, Yamanaka A, Zeitune JM, Andreollo NA. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies. Arq Gastroenterol 2007;44:14-7.
  • 3. Soytürk M, Akkaya Özdinç S, Sarıoğlu S, et al. Location of endoscopic examination-detected gastric polyps, histopathological types and association with Helicobacter pylori. Endoscopy 2012;20:01-04.
  • 4. Zea-lrlarte WL, Sekine I, Itsuno M, et al. Carcinoma in gastric hyperplastic polyps: a phenotypic study. Dig Dis Sci 1996;41:377-86.
  • 5. Dirschmid K, Platz-Baudin C, Stolte M. Why is the hyperplastic polyp a marker for the precancerous condition of the gastric mucosa? Virchows Arch 2006;448:80-4.
  • 6. Turner JR, Odze RD. Polyps of the stomach. In: Odze RD, Goldblum JR, Eds. Surgical pathology of the GI tract, liver, biliar tract, and pancreas. 3nd ed. Saunders Elsevier, Philadelphia (Pa), 2015;540-78.
  • 7. Karagülle OO, Yavuz E. Assessment of the polypoid lesions deteced in upper gastrointestinal system endoscopies. IKSSTD 2020;12:63-8.
  • 8. Demiryilmaz I, Albayrak Y, Yilmaz SP. Frequency of various types of gastric polyp. Cumhuriyet Med J 2011;33:209-14.
  • 9. Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, et al. Gastric polypoid lesions: analysis of 150 endoscopic polypectomy specimens from 91 patients. World J Gastroenterol 2003;9:2236-9.
  • 10. Sülü B, Demir E, Günerhan Y. Endoscopic diagnosis and management of gastric polyps: A clinical study. Turkish journal of Surgery 2012;28:17-20.
  • 11. Carmack SW, Genta RM, Graham DY, Lauwers GY. Management of gastric polyps: a pathology-based guide for gastroenterologists. Nat Rev Gastroenterol Hepatol 2009;6:331-41.
  • 12. Di Giulio E, Lahner E, Micheletti A, et al. Occurrence and risk factors for benign epithelial gastric polyps in atrophic body gastritis on diagnosis and follow-up. Aliment Pharmacol Ther 2005;21:567-74.
  • 13. Abraham SC, Singh VK, Yardley JH, Wu TT. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol 2001;25:500-7.
  • 14. Vatansever S, Akpınar Z, Alper E, et al. Gastric polyps and polypoid lesions: Retrospective analysis of 36650 endoscopic procedures in 29940 patients. Turk J Gastroenterol 2015;26:117-22.
  • 15. Melton SD, Genta RM. Gastric cardiac polyps: a clinicopathologic study of 330 cases. Am J Surg Pathol 2010;34:1792-7.
  • 16. Archimandritis A, Spiliadis C, Tzivras M, et al. Gastric epithelial polyps: a retrospective endoscopic study of 12974 symptomatic patients. Ital J Gastroenterol 1996;28:387-90.
  • 17. Matysiak-Budnik T, Mégraud F. Helicobacter pylori infection and gastric cancer. Eur J Cancer 2006;42:708-16.
  • 18. Ji F, Wang ZW, Ning JW, et al. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: a randomized, controlled trial. World J Gastroenterol 2006;12:1770-3.
  • 19. Karaman A, Deniz K, Karaman H, et al. Prevalence and histopathological condition of gastric polyps in Central Anatolia. Endoskopi 2011;19:56-8.
  • 20. Zullo A, Hassan C, Romiti A, et al. Follow-up of intestinal metaplasia in the stomach: When, how and why. World J Gastrointest Oncol 2012;4:30-6.
  • 21. Aygün C, Demirci E, Çayırcı M. Prevalence of gastric cancer precursor lesions in patients with dyspepsia. Dicle Med J 2010;37:25-9.

Mide hiperplastik polipleri ve öncül lezyonlarının değerlendirilmesi

Year 2021, Volume: 20 Issue: 1, 3 - 7, 14.05.2021
https://doi.org/10.17941/agd.927776

Abstract

Giriş ve Amaç: Mide poliplerinin yaklaşık %75-90 kadarını hiperplastik polipler oluşturur. Kronik inflamasyon nedenli epitelin aşırı rejenerasyonuna bağlı, foveolar hiperplazi ve kronik gastrit sonrasında bu öncül lezyonlardan hiperplastik polipler oluşur. Bu çalışmada mide hiperplastik polipler ve öncül lezyonlarının Helicobacter pylori ile ilişkisi ve bu lezyonların intestinal metaplazi, atrofi durumlarının literatür bilgileri eşliğinde tartışılması amaçlanmıştır. Gereç ve Yöntem: Muş Devlet Hastanesi Endoskopi ünitesinde Ocak 2016-Ocak 2020 tarihleri arasında özofagogastroduodenoskopi yapılan 7903 hastadan endoskopik görünümü polipoid yapıda olan 172 hastanın histopatolojileri değerlendirildi. Hastaların yaşı, cinsiyeti, başvuru şikâyeti, polipoid görünümlü lezyonun yeri, lezyonların histopatolojik tipi kaydedildi. Bulgular: 172 hastaya polipektomi yapıldı. Hastaların 71’i erkek (%41.2), 101’i kadın (%58.8) olup, yaş ortalamaları 49.4 ± 15 (19-83) yıldı. Hastalar reaktif polipoid lezyonlar; foveolar hiperplazi 57 hasta, kronik gastrit 53 hasta ve gerçek polipoid 62 hasta (en sık hiperplastik polip 47 hasta %75) olarak iki gruba ayrıldı. Polipoid görünümlü lezyonlar en fazla antrumda lokalize idi. Hastaların başvuru şikayeti her iki grupta en fazla dispepsi idi. Gerçek polip lezyonlarının çapı, reaktif polipoid lezyonların çapından istatistiksel olarak büyük saptandı (p < 0.05). Helicobacter pylori oranı reaktif polipoid grupta istatistiksel olarak daha yüksek bulundu (p < 0.05). İntestinal metaplazi ve atrofi durumu açısından fark saptanmadı (p > 0.05). Sonuç: Hiperplastik polipler ve öncül lezyonlarının prekanseröz durumlar olan atrofi ve intestinal metaplazi oranları arasında anlamlı fark saptanmamıştır. Bu yüzden endoskopide saptanan lezyonlardan tanı ve displazinin varlığını saptamak için biyopsi alınmalı ya da eksize edilmeli ve Helicobacter pylori saptanan hastalar tedavi edilmelidir.

References

  • 1. Şen Oran E, Gençosmanoğlu R. Midenin hiperplastik polipleri: Tanı, tedavi ve izlemde güncel yaklaşımlar. Güncel Gastroenteroloji 2003;7:127-35.
  • 2. Morais DJ, Yamanaka A, Zeitune JM, Andreollo NA. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies. Arq Gastroenterol 2007;44:14-7.
  • 3. Soytürk M, Akkaya Özdinç S, Sarıoğlu S, et al. Location of endoscopic examination-detected gastric polyps, histopathological types and association with Helicobacter pylori. Endoscopy 2012;20:01-04.
  • 4. Zea-lrlarte WL, Sekine I, Itsuno M, et al. Carcinoma in gastric hyperplastic polyps: a phenotypic study. Dig Dis Sci 1996;41:377-86.
  • 5. Dirschmid K, Platz-Baudin C, Stolte M. Why is the hyperplastic polyp a marker for the precancerous condition of the gastric mucosa? Virchows Arch 2006;448:80-4.
  • 6. Turner JR, Odze RD. Polyps of the stomach. In: Odze RD, Goldblum JR, Eds. Surgical pathology of the GI tract, liver, biliar tract, and pancreas. 3nd ed. Saunders Elsevier, Philadelphia (Pa), 2015;540-78.
  • 7. Karagülle OO, Yavuz E. Assessment of the polypoid lesions deteced in upper gastrointestinal system endoscopies. IKSSTD 2020;12:63-8.
  • 8. Demiryilmaz I, Albayrak Y, Yilmaz SP. Frequency of various types of gastric polyp. Cumhuriyet Med J 2011;33:209-14.
  • 9. Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, et al. Gastric polypoid lesions: analysis of 150 endoscopic polypectomy specimens from 91 patients. World J Gastroenterol 2003;9:2236-9.
  • 10. Sülü B, Demir E, Günerhan Y. Endoscopic diagnosis and management of gastric polyps: A clinical study. Turkish journal of Surgery 2012;28:17-20.
  • 11. Carmack SW, Genta RM, Graham DY, Lauwers GY. Management of gastric polyps: a pathology-based guide for gastroenterologists. Nat Rev Gastroenterol Hepatol 2009;6:331-41.
  • 12. Di Giulio E, Lahner E, Micheletti A, et al. Occurrence and risk factors for benign epithelial gastric polyps in atrophic body gastritis on diagnosis and follow-up. Aliment Pharmacol Ther 2005;21:567-74.
  • 13. Abraham SC, Singh VK, Yardley JH, Wu TT. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol 2001;25:500-7.
  • 14. Vatansever S, Akpınar Z, Alper E, et al. Gastric polyps and polypoid lesions: Retrospective analysis of 36650 endoscopic procedures in 29940 patients. Turk J Gastroenterol 2015;26:117-22.
  • 15. Melton SD, Genta RM. Gastric cardiac polyps: a clinicopathologic study of 330 cases. Am J Surg Pathol 2010;34:1792-7.
  • 16. Archimandritis A, Spiliadis C, Tzivras M, et al. Gastric epithelial polyps: a retrospective endoscopic study of 12974 symptomatic patients. Ital J Gastroenterol 1996;28:387-90.
  • 17. Matysiak-Budnik T, Mégraud F. Helicobacter pylori infection and gastric cancer. Eur J Cancer 2006;42:708-16.
  • 18. Ji F, Wang ZW, Ning JW, et al. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: a randomized, controlled trial. World J Gastroenterol 2006;12:1770-3.
  • 19. Karaman A, Deniz K, Karaman H, et al. Prevalence and histopathological condition of gastric polyps in Central Anatolia. Endoskopi 2011;19:56-8.
  • 20. Zullo A, Hassan C, Romiti A, et al. Follow-up of intestinal metaplasia in the stomach: When, how and why. World J Gastrointest Oncol 2012;4:30-6.
  • 21. Aygün C, Demirci E, Çayırcı M. Prevalence of gastric cancer precursor lesions in patients with dyspepsia. Dicle Med J 2010;37:25-9.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Rıfat Peksöz 0000-0003-4658-5254

Ali Mızrak This is me 0000-0002-1096-1660

Publication Date May 14, 2021
Published in Issue Year 2021 Volume: 20 Issue: 1

Cite

APA Peksöz, R., & Mızrak, A. (2021). Mide hiperplastik polipleri ve öncül lezyonlarının değerlendirilmesi. Akademik Gastroenteroloji Dergisi, 20(1), 3-7. https://doi.org/10.17941/agd.927776

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