[Is gastroscopic polypectomy a diagnostic necessity? Results of a prospective study]

In a prospective study 76 gastric polyps (of 67 patients) were investigated consecutively by forceps biopsy and by endoscopic polypectomy. The results were compared histologically. Differences arose only in the group where focal foveolar hyperplasia had been diagnosed by forceps biopsy. Of these, 33 remained with the same diagnosis on microscopic assessment of the whole polyp, 14 were hyperplasiogenic polyps, 7 fibrous-inflammatory polyps and in one case there were cysts of the glandular body. A clinically relevant difference was observed in only one polyp where biopsy in toto showed a borderline lesion whereas forceps biopsy had only shown focal foveolar hyperplasia. Critical reevaluation of the specimens led to reassignment as focal foveolar hyperplasia and intestinal metaplasia. There were no differences of histology in the group of adenocarcinoma, adenomas and borderline lesions. Thus, endoscopic forceps biopsy of gastric polyps suffices to reliably differentiate benign from malignant polyps including those which are considered precancerous.