Anatomic-size determinants drive therapeutic decisions in inflammatory fibroid polyps: a retrospective study

Inflammatory fibroid polyps (IFPs), uncommon benign growths in the gastrointestinal tract, currently lack standardized treatment protocols. Our investigation sought to determine crucial clinical indicators for therapeutic decision-making in IFP management.

We conducted a retrospective analysis of 114 hospitalized patients from The First Affiliated Hospital of Fujian Medical University and Fuzhou University Affiliated Provincial Hospital between January 2015 and April 2025. Comprehensive evaluation included patient demographics, lesion features (anatomical distribution, dimensions, pathological characteristics), and therapeutic outcomes. Statistical approaches incorporated independent sample t-tests, χ²analyses, and generalized estimating equations (GEE) to adjust for clustered lesions. The threshold for surgical consideration based on lesion size was established through receiver operating characteristic (ROC) evaluation.

The study cohort demonstrated a significant female predominance (male-to-female ratio 1:2.2), with gender showing a significant association with IFP surface morphology (p = 0.023), median patient age of 57.92 years with the majority asymptomatic (69.3%), anatomical distribution: gastric (73.8%), colorectal (15.6%), and small intestinal (10.7%). Absolute surgical indication for small intestinal IFPs (vs stomach, OR = 20.624, p < 0.001). Markedly increased surgical likelihood for lesions exceeding 1.65 cm (area under curve 0.859; 82.6% sensitivity, 74.7% specificity). Differential complication rates: surgery cohort 30.4% vs endoscopy 7.7% (p = 0.008).

Our research establishes a novel dual-parameter decision framework for IFP treatment: anatomic-driven, lesions in the jejunum and ileum warrant primary surgical resection; size-dependent, 1.65 cm cutoff optimizes endoscopic safety for gastric/colorectal lesions. This discovery provides an evidence-based basis for individualized diagnosis and treatment of IFP.