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[Gastric epithelial polyps (part two)].

Luis Hernán Espejo Romero1, Jesús Navarrete Siancas

  • 1Clínica Médica de la UNMSM, and Propedéutica y Clínica de la Universidad San Martín de Porres.

Revista De Gastroenterologia Del Peru : Organo Oficial De La Sociedad De Gastroenterologia Del Peru
|April 21, 2004
PubMed
Summary

Gastric polyps, including hyperplastic polyps and adenomas, were analyzed for frequency, characteristics, and malignant potential. Adenomas showed a higher risk of malignancy, particularly those larger than 20 mm.

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[Gastric epithelial polyps (first part)].

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Area of Science:

  • Gastroenterology
  • Pathology
  • Oncology

Background:

  • Gastric polyps are common findings during endoscopic examinations.
  • Understanding the characteristics and malignant potential of different polyp types is crucial for patient management.

Purpose of the Study:

  • To statistically analyze the frequency, topography, morphology, and malignant potential of gastric polyps, specifically hyperplastic polyps and adenomas.
  • To investigate the association between polyp characteristics, patient age, metaplasia, and gastric acidity.

Main Methods:

  • Retrospective analysis of endoscopic and histopathological data from 2,283 gastric polyps.
  • Classification of polyps into hyperplastic and adenomatous types.
  • Assessment of polyp topography, morphology (sessile vs. pediculate), size, and Nakamura classification.

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  • Evaluation of metaplasia in polyps and adjacent areas.
  • Analysis of gastric acidity (D.A.B. and D.A.M.) in a subset of patients.

    • Main Results:

    • Gastric polyps were found in 3.6% of endoscopic examinations.
    • Hyperplastic polyps constituted 86% and adenomas 14% of all polyps.
    • Adenomas were more frequently found in the antrum (65%) compared to hyperplastic polyps (17%).
    • Adenomas were predominantly sessile (86%), while hyperplastic polyps were evenly distributed (49% pediculate, 51% sessile).
    • The average age of patients with adenomas was 66.2 years, higher than those with hyperplastic polyps (58.5 years).
    • Malignancy risk in adenomas increased significantly with size, reaching 86.2% for polyps over 40 mm, with an overall adenoma malignancy rate of 18%.
    • Hyperplastic polyp malignancy was low at 0.8%.
    • Achlorhydria was prevalent (60%) in patients with hyperplastic polyps.

    Conclusions:

    • Adenomas represent a significant malignant risk, especially when larger than 20 mm.
    • Hyperplastic polyps are more common but have a very low malignant potential.
    • Gastric acidity, particularly achlorhydria, may be associated with hyperplastic polyps.