Risk factor-based optimal endoscopic surveillance intervals after endoscopic submucosal dissection for gastric adenoma

Evaluating the detection rate and pathological features of polyps in patients with upper gastrointestinal endoscopy

BACKGROUND

The incidence of gastric polyps (GPs) has ranged from 0.30% to 6.8% in various studies. Most GPs include hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high malignant potential, HPs have a low risk of potential harm, whereas sporadic FGPs have no malignant potential. It is not enough to determine the type and displacement of a polyp by biopsy alone; therefore, some polyps may require an extensive biopsy or complete resection.

AIM

To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.

METHODS

This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.

RESULTS

In a series of 10000 patients who underwent upper gastrointestinal endoscopy, 384 (3.84%) had GPs. There were 98 males (25.5%) and 286 females (74.5%). The mean age of patients was 62.8 ± 10.4 (36-75) years. The frequencies of HPs, APs, and FGPs were 88.5%, 5.2%, and 2.1%, respectively. The polyp size of 274 patients (71.3%) was ≤ 1 cm. Polyps were found in 262 cases (68.2%). The most common sites for polyps were the lumen and body of the intestine. Endoscopic polypectomy was performed in 128 patients. Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.

CONCLUSION

The incidence of GPs was low. HPs were the most common types of GPs. Of note, as GPs have the potential to develop into adenocarcinoma or precancerous lesions, we suggest that appropriate GP resection technology (e.g., biopsy forceps or mesenchymal resection) be applied.