Clinical Factors for Consideration in Patients with Gastric Hyperplastic Polyps Treated by Endoscopic Polypectomy

Hwang, Se Woong; Jeong, Hyun Yong; Sung, Jae Kyu; Moon, Hee Seok; Kang, Sun Hyung; Yoon, Beom Yong; Park, Se Young; Kim, Hye Jin; Song, Kyu Sang

Abstract

BACKGROUND/AIMS
Hyperplastic polyps are the most common type of gastric polyps that constitute 30~93% of all benign epithelial gastric polyps. The overall prevalence of dysplasia in patients with hyperplastic polyps is believed to be <2%, and higher in patients with large polyps (>2 cm). We aimed to identify the clinical features of hyperplastic polyps that undergo neoplastic transformation.
MATERIALS AND METHODS
Between March 2011 and June 2013, 315 hyperplastic polyps that were removed by endoscopic polypectomy from 217 patients were analyzed retrospectively.
RESULTS
Neoplastic transformations were found in 5 cases (1.6%), including 3 cases of adenoma (1.0%) and 2 cases of adenocarcinoma (0.6%). Polypectomy-associated complications were noted in only 2 cases (0.6%), which were bleeding in both cases. Neoplastic transformation was significantly associated with the absence of hyperemia on endoscopy (non-neoplastic transformation group, n=26 [8.4%] vs. neoplastic transformation group, n=3 [60%]; P=0.006). However, no other significant differences was found between these groups in terms of age, sex, presence of Helicobacter pylori, size, location, number of detected polyps in each patient, and endoscopic appearances such as nodular changes or erosions and shape.
CONCLUSIONS
No clinical factors were associated with the neoplastic transformation of hyperplastic polyps. In addition, neoplastic transformations were almost impossible to identify using endoscopy. Therefore, endoscopic polypectomy could be considered for the accurate diagnosis and definitive treatment of gastric hyperplastic polyps <1 cm in size.