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Frequency of various types of gastric polyp

Yıl 2011, Cilt: 33 Sayı: 2, 209 - 214, 20.06.2011

Öz

Abstract

Aim. Any discrete lesion protruding into the lumen of gastrointestinal tract detected by endoscopy is called as “polypoid lesion”. Thus, we aimed to study the demographic, clinical, and endoscopic characteristics of patients with gastric polypoid lesions. Method. Upper gastrointestinal system endoscopy was carried out in a total of 3375 patients between the dates of October 2006-July 2010. In 66 (1.95%) of these patients polypoid lesions were observed in various anatomical sites of the stomach, and polypectomy was performed. Sixty six patients who had gastric polyp or polpys were included in this study. The localization, size, histopathological findings and treatment of the polyps were recorded. All patients had at least one gastric polyp confirmed by histological examination. Results. The most frequent presenting symptom was epigastric pain (72.7%) followed by dyspepsia (18%), and anemia (4.5%). Fifty-one of the patients had one, 8 had two and 7 had three polyps. Out of 88 gastric polypoid lesions, 41 (46.5%) were located in the antrum followed by 26 (29.5%) in corpus, 12 (13.6%) in cardia, and 9 (10.4%) in around anastomoses. Fifty-three (60.2%) of the polyps were smaller than 1 cm, 23 (26.1%) were between 1-2 cm, and 12 (13.7%) were larger than 2 cm. In the histopathological examination of the polyps, 71 (80.7%) were found to be hyperplastic polyps, 15 (17%) were inflammatory polyps and 2 (2.3%) were adenomatous polyps. All patients with multiple polyps had only a single histological type. Conclusion. For this reason, endoscopic polypectomy to be a sensible diagnostic and therapeutic procedure of gastric polyps when feasible. Finally, endoscopic surveillance in these patients may be recommended to exclude both possibility of recurrence and cancer development elsewhere in stomach.

Keywords: Gastric polyp, hyperplastic polyp, inflammatory polyp, adenomatous polyp, polypectomy

 

Özet

Amaç. Endoskopik olarak görülen gastrointestinal sistemin lümenine çıkıntı oluşturan herhangi bir lezyon polipoid lezyon olarak adlandırılır. Çalışmamızda, gastrik polipoid lezyonlu hastaların demografik, klinik ve endoskopik özelliklerinin incelemeyi amaçladık. Yöntem. Ekim 2006 ile Temmuz 2010 tarihleri arasında toplam 3375 hastaya üst gastrointestinal sistem endoskopisi yapıldı. Bu hastaların 66 (%1,95)’sında midenin çeşitli anatomik pozisyonlarında polipoid lezyon görülerek bunlara polipektomi yapılmıştı. Gastrik polip tespit edilen 66 hastadaki gastrik polip ve/veya poliplerin lokalizasyon, boyut, histopatolojik bulguları ve tedavileri üzerinde duruldu. Tüm hastaların histolojik inceleme ile doğrulanmış en az bir polibi mevcuttu. Bulgular. Hastalarda görülen en sık şikayet %72,7 ile epigastrik ağrı daha sonra ise dispepsi (%18) ve anemi (%4,5) idi. Hastaların 51’inde bir adet, 8’inde iki ve 7’sinde üç adet polip mevcuttu. Toplam 88 adet gastrik polipoid lezyonun 41 (%46,5)’i antrumda, 26 (%29,5)’sı korpusta, 12 (%13,6)’si kardiada ve 9 (%10,4)’u anastomoz sahasında lokalize idi. Poliplerin 53 (%60,2)’ü 1 cm’den küçük, 23 (%26,1)’ü 1-2 cm arasında ve 12 (%13,7)’si 2 cm’den daha büyüktü. Poliplerin histopatolojik incelemesinde 71 (%80,7)’inde hiperplastik polip, 15 (%17)’inde inflamatuar polip ve 2 (%2,3)’sinde adenomatöz polip tespit edildi. Birden fazla polibe sahip hastaların tümü tek bir histopatolojik tipe sahipti. Sonuç. Endoskopik polipektomi gastrik poliplerin teşhis ve tedavisinde duyarlı bir yöntemdir. Sonuç olarak; gastrik polipli hastalarda hem nüks ihtimalini ortadan kaldırmak hemde midenin başka bir yerinde kanser gelişimini engellemek için endoskopi ile takip yapılmalıdır.

Anahtar sözcükler: Gastrik polip, hiperplastik polip, inflamatuar polip, adenomatöz polip, polipektomi

Kaynakça

  • Crawford JM. The gastrointestinal tract. In: Cotran RS, Kumar V, Robbins SL, eds. Pathologic Basis of Disease. 6th ed. Philadelphia: W. B. Saunders Company 1999; pp: 775-843.
  • Oberhuber G, Stolte M. Gastric polyps: an update of their pathology and biological significance. Virchows Arch 2000; 437: 581-90.
  • Cristallini EG, Ascani S, Bolis GB. Association between histological type of polyp and carcinoma in the stomach. Gastrointest Endosc 1992; 38: 481-4.
  • Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995; 90: 2152-9.
  • Harju E. Gastric polyposis and malignancy. Br J Surg 1986; 7:532-3.
  • Stolte M, Sticht T, Eidt S, Ebert D, Finkenzeller G. Frequency, location, and age and sex distribution of various types of gastric polyp. Endoscopy 1994; 26: 659- 65.
  • Stolte M, Finkenzeller G. Inflammatory fibroid polyp of the stomach. Endoscopy 1990; 22: 203-7.
  • Morais DJ, Yamanaka A, Zeitune JM, Andreollo NA. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies. Arq Gastroenterol 2007; 44: 14-7.
  • Deppish LM, Rona VT. Gastric epithelial polyps: a 10-year study. J Clin Gastroenterol 1989; 11: 110-5.
  • Sivelli R, Del Rio P, Bonati L, Sianesi M. Gastric polyps: a clinical contribution. Chir Ital 2002; 54: 37-40.
  • Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Avsar E, Sav A, Tozun N. Gastric polypoid lesions: analysis of 150 endoscopic polypectomy specimens from 91 patients. World J Gastroenterol 2003; 9: 2236-9.
  • Li WB, Zuo XL, Zuo F, Gu XM, Yu T, Zhao YA, Zhang TG, Zhang JP, Li YQ. Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy. Surg Endosc 2010; 24:517-24.
  • Ginsberg GG, Al-Kawas FH, Fleischer DE, Reilly HF, Benjamin SB. Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol 1996; 91: 714-7.
  • Dean PG, Davis PM, Nascimento AG, Farley DR. Hyperplastic gastric polyp causing progressive gastric outlet obstruction. Mayo Clin Proc 1998; 73: 964-7.
  • DaiboM, Itabashi M, Hirota T. Malignant trasformation of gastric hyperplastic polyps. Am J Gastroenterol 1987; 82: 1016-25.
  • Davaris P, Petraki K, Archimandritis A, Haritopoulos N, Papacharalampous N. Mucosal hyperplastic polyps of the stomach. Do they have any potential to malignancy? Pathol Res Pract 1986; 181: 385-9.
  • Hizawa K, Fuchigami T, lida M, Aoyagi K, Iwashita A, Daimaru Y, Fujishima M. Possible neoplastic transformation within gastric hyperplastic polyp. Application of endoscopic polypectomy. Surg Endosc 1995; 9: 714-8.
  • Zea-Iriarte WL, Sekine I, Itsuno M, Makiyama K, Naito S, Nakayama T, Nishisawa-Takano JE, Hattori T. Carcinoma in gastric hyperplastic polyps: a phenotypic study. Dig Dis Sci 1996; 41: 377-86.
  • 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.
  • Malaty, HM. Epidemiology of Helicobacter pylori infection. Best Pract Res Clin Gastroenterol 2007; 21: 205-14.
  • 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.
  • Cerwenka H, Bacher H, Mischinger HJ. Pyloric obstruction caused by prolapse of a hyperplastic gastric polyp. Hepatogastroenterology 2002; 49: 958-60.
  • Vanek J: Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol 1949; 25: 397-411.
  • Schroeder BA, Wells RG, Sty JR. Inflammatory fibroid polyp of the stomach in a child. Pediatr Radiol 1987; 17: 71-2.
  • Blackshaw AJ, Levison DA. Eosinophilic infiltrates of the gastrointestinal tract. J Clin Pathol 1986; 39: 1-7.
  • Matsuhashi N, Nakajima A, Nomura S, Kaminishi M. Inflammatory fibroid polyps of the stomach and Helicobacter pylori. J Gastroenterol Hepatol 2004; 19: 346-7.
  • Buciuto R, Kullman E, Boeryd B, Borch K. Helicobacter pylori gastritis associated with a gastric inflammatory fibroid tumour and sarcoidosis. Eur J Surg 1996; 162: 421-4.
  • Matsushita M, Hajiro K, Okazaki K, Takakuwa H. Endoscopic features of gastric inflammatory fibroid polyps. AmJ Gastroenterol 1996; 91: 1595-8.
  • Kolodziejczyk P, Yao T, Tsuneyoshi M. Inflammatory fibroid polyp of the stomach. a special reference to an immunohistochemical profile of 42 cases. Am J Surg Pathol 1993;17: 1159-68.
  • Rochat CH, Widgren S, Rohner A. Inflammatory fibroid polyps of the digestive tract. Apropos of 5 cases. Schweiz Med Wochenschr 1983; 113: 1609-16.
  • Nakamura, T, Nakano G. Histopathological classification and malignant change in gastric polyps. J Clin Pathol 1985; 38: 754-64.
  • Yoshihara M, Sumii K, Haruma K, Kiyohira K, Hattori N, Kitadai Y, Komoto K, Tanaka S, Kajiyama G. Correlation of ratio of serum pepsinogen I and II with prevalence of gastric cancer and adenoma in Japanese subjects. Am. J. Gastroenterol 1998; 93, 1090-6.
  • Ming SC, Goldman H. Gastric polyps; a histogenetic classification and its relation to carcinoma. Cancer 1965; 18: 721-6.
  • Kolodziejczyk P, Yao T, Oya M, Nakamura S, Utsunomiya T, Ishikawa T, Tsuneyoshi M. Long term follow-up study of patients with gastric adenomas with malignant transformation. Cancer 1994; 74: 2896-907.
  • Lau CF, Hui PK, Mak KL, Wong AM, Yee KS, Loo CK, Lam KM. Gastric polypoid lesions-illustrative cases and literature review. Am J Gastroenterol 1998; 93: 2559-64.
  • Muehldorfer SM, Stolte M, Martus P, Hahn EG, Ell C; Multicenter Study Group "Gastric Polyps". Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut 2002; 50: 465-70.
  • Seifert E, Elster K. Gastric polypectomy. Am J Gastroenterol 1975; 63: 451-6.

Original research-Orijinal araştırma

Yıl 2011, Cilt: 33 Sayı: 2, 209 - 214, 20.06.2011

Öz

Amaç. Endoskopik olarak görülen gastrointestinal sistemin lümenine çıkıntı oluşturan herhangi bir lezyon polipoid lezyon olarak adlandırılır. Çalışmamızda, gastrik polipoid lezyonlu hastaların demografik, klinik ve endoskopik özelliklerinin incelemeyi amaçladık. Yöntem. Ekim 2006 ile Temmuz 2010 tarihleri arasında toplam 3375 hastaya üst gastrointestinal sistem endoskopisi yapıldı. Bu hastaların 66 (%1,95)’sında midenin çeşitli anatomik pozisyonlarında polipoid lezyon görülerek bunlara polipektomi yapılmıştı. Gastrik polip tespit edilen 66 hastadaki gastrik polip ve/veya poliplerin lokalizasyon, boyut, histopatolojik bulguları ve tedavileri üzerinde duruldu. Tüm hastaların histolojik inceleme ile doğrulanmış en az bir polibi mevcuttu. Bulgular. Hastalarda görülen en sık şikayet %72,7 ile epigastrik ağrı daha sonra ise dispepsi (%18) ve anemi (%4,5) idi. Hastaların 51’inde bir adet, 8’inde iki ve 7’sinde üç adet polip mevcuttu. Toplam 88 adet gastrik polipoid lezyonun 41 (%46,5)’i antrumda, 26 (%29,5)’sı korpusta, 12 (%13,6)’si kardiada ve 9 (%10,4)’u anastomoz sahasında lokalize idi. Poliplerin 53 (%60,2)’ü 1 cm’den küçük, 23 (%26,1)’ü 1-2 cm arasında ve 12 (%13,7)’si 2 cm’den daha büyüktü. Poliplerin histopatolojik incelemesinde 71 (%80,7)’inde hiperplastik polip, 15 (%17)’inde inflamatuar polip ve 2 (%2,3)’sinde adenomatöz polip tespit edildi. Birden fazla polibe sahip hastaların tümü tek bir histopatolojik tipe sahipti. Sonuç. Endoskopik polipektomi gastrik poliplerin teşhis ve tedavisinde duyarlı bir yöntemdir. Sonuç olarak; gastrik polipli hastalarda hem nüks ihtimalini ortadan kaldırmak hemde midenin başka bir yerinde kanser gelişimini engellemek için endoskopi ile takip yapılmalıdır

Kaynakça

  • Crawford JM. The gastrointestinal tract. In: Cotran RS, Kumar V, Robbins SL, eds. Pathologic Basis of Disease. 6th ed. Philadelphia: W. B. Saunders Company 1999; pp: 775-843.
  • Oberhuber G, Stolte M. Gastric polyps: an update of their pathology and biological significance. Virchows Arch 2000; 437: 581-90.
  • Cristallini EG, Ascani S, Bolis GB. Association between histological type of polyp and carcinoma in the stomach. Gastrointest Endosc 1992; 38: 481-4.
  • Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995; 90: 2152-9.
  • Harju E. Gastric polyposis and malignancy. Br J Surg 1986; 7:532-3.
  • Stolte M, Sticht T, Eidt S, Ebert D, Finkenzeller G. Frequency, location, and age and sex distribution of various types of gastric polyp. Endoscopy 1994; 26: 659- 65.
  • Stolte M, Finkenzeller G. Inflammatory fibroid polyp of the stomach. Endoscopy 1990; 22: 203-7.
  • Morais DJ, Yamanaka A, Zeitune JM, Andreollo NA. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies. Arq Gastroenterol 2007; 44: 14-7.
  • Deppish LM, Rona VT. Gastric epithelial polyps: a 10-year study. J Clin Gastroenterol 1989; 11: 110-5.
  • Sivelli R, Del Rio P, Bonati L, Sianesi M. Gastric polyps: a clinical contribution. Chir Ital 2002; 54: 37-40.
  • Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Avsar E, Sav A, Tozun N. Gastric polypoid lesions: analysis of 150 endoscopic polypectomy specimens from 91 patients. World J Gastroenterol 2003; 9: 2236-9.
  • Li WB, Zuo XL, Zuo F, Gu XM, Yu T, Zhao YA, Zhang TG, Zhang JP, Li YQ. Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy. Surg Endosc 2010; 24:517-24.
  • Ginsberg GG, Al-Kawas FH, Fleischer DE, Reilly HF, Benjamin SB. Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol 1996; 91: 714-7.
  • Dean PG, Davis PM, Nascimento AG, Farley DR. Hyperplastic gastric polyp causing progressive gastric outlet obstruction. Mayo Clin Proc 1998; 73: 964-7.
  • DaiboM, Itabashi M, Hirota T. Malignant trasformation of gastric hyperplastic polyps. Am J Gastroenterol 1987; 82: 1016-25.
  • Davaris P, Petraki K, Archimandritis A, Haritopoulos N, Papacharalampous N. Mucosal hyperplastic polyps of the stomach. Do they have any potential to malignancy? Pathol Res Pract 1986; 181: 385-9.
  • Hizawa K, Fuchigami T, lida M, Aoyagi K, Iwashita A, Daimaru Y, Fujishima M. Possible neoplastic transformation within gastric hyperplastic polyp. Application of endoscopic polypectomy. Surg Endosc 1995; 9: 714-8.
  • Zea-Iriarte WL, Sekine I, Itsuno M, Makiyama K, Naito S, Nakayama T, Nishisawa-Takano JE, Hattori T. Carcinoma in gastric hyperplastic polyps: a phenotypic study. Dig Dis Sci 1996; 41: 377-86.
  • 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.
  • Malaty, HM. Epidemiology of Helicobacter pylori infection. Best Pract Res Clin Gastroenterol 2007; 21: 205-14.
  • 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.
  • Cerwenka H, Bacher H, Mischinger HJ. Pyloric obstruction caused by prolapse of a hyperplastic gastric polyp. Hepatogastroenterology 2002; 49: 958-60.
  • Vanek J: Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol 1949; 25: 397-411.
  • Schroeder BA, Wells RG, Sty JR. Inflammatory fibroid polyp of the stomach in a child. Pediatr Radiol 1987; 17: 71-2.
  • Blackshaw AJ, Levison DA. Eosinophilic infiltrates of the gastrointestinal tract. J Clin Pathol 1986; 39: 1-7.
  • Matsuhashi N, Nakajima A, Nomura S, Kaminishi M. Inflammatory fibroid polyps of the stomach and Helicobacter pylori. J Gastroenterol Hepatol 2004; 19: 346-7.
  • Buciuto R, Kullman E, Boeryd B, Borch K. Helicobacter pylori gastritis associated with a gastric inflammatory fibroid tumour and sarcoidosis. Eur J Surg 1996; 162: 421-4.
  • Matsushita M, Hajiro K, Okazaki K, Takakuwa H. Endoscopic features of gastric inflammatory fibroid polyps. AmJ Gastroenterol 1996; 91: 1595-8.
  • Kolodziejczyk P, Yao T, Tsuneyoshi M. Inflammatory fibroid polyp of the stomach. a special reference to an immunohistochemical profile of 42 cases. Am J Surg Pathol 1993;17: 1159-68.
  • Rochat CH, Widgren S, Rohner A. Inflammatory fibroid polyps of the digestive tract. Apropos of 5 cases. Schweiz Med Wochenschr 1983; 113: 1609-16.
  • Nakamura, T, Nakano G. Histopathological classification and malignant change in gastric polyps. J Clin Pathol 1985; 38: 754-64.
  • Yoshihara M, Sumii K, Haruma K, Kiyohira K, Hattori N, Kitadai Y, Komoto K, Tanaka S, Kajiyama G. Correlation of ratio of serum pepsinogen I and II with prevalence of gastric cancer and adenoma in Japanese subjects. Am. J. Gastroenterol 1998; 93, 1090-6.
  • Ming SC, Goldman H. Gastric polyps; a histogenetic classification and its relation to carcinoma. Cancer 1965; 18: 721-6.
  • Kolodziejczyk P, Yao T, Oya M, Nakamura S, Utsunomiya T, Ishikawa T, Tsuneyoshi M. Long term follow-up study of patients with gastric adenomas with malignant transformation. Cancer 1994; 74: 2896-907.
  • Lau CF, Hui PK, Mak KL, Wong AM, Yee KS, Loo CK, Lam KM. Gastric polypoid lesions-illustrative cases and literature review. Am J Gastroenterol 1998; 93: 2559-64.
  • Muehldorfer SM, Stolte M, Martus P, Hahn EG, Ell C; Multicenter Study Group "Gastric Polyps". Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut 2002; 50: 465-70.
  • Seifert E, Elster K. Gastric polypectomy. Am J Gastroenterol 1975; 63: 451-6.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Cerrahi Tıp Bilimleri Araştırma Yazıları
Yazarlar

Yavuz Albayrak

İsmail Demiryılmaz

Serpil Yılmaz

Yayımlanma Tarihi 20 Haziran 2011
Yayımlandığı Sayı Yıl 2011Cilt: 33 Sayı: 2

Kaynak Göster

AMA Albayrak Y, Demiryılmaz İ, Yılmaz S. Frequency of various types of gastric polyp. CMJ. Haziran 2011;33(2):209-214.