Gastric Hyperplastic Polyps: a Benign Entity? Analysis Of Recurrence And Neoplastic Transformation in a Cohort Study

Aims Hyperplastic polyps represent 30-93 % of all gastric epithelial polyps. They are generally detected as innocuous incidental findings; however, they have risk of neoplastic transformation and recurrence. Frequency and risk factors for neoplastic transformation and recurrence are not well established and are fields of on-going interest. This study aims at evaluating the frequency and identifying risk factors for recurrence and neoplastic change of gastric hyperplastic polyps (GHP).

Methods Single centre retrospective cohort study including consecutive patients who underwent endoscopic resection of GHP from January 2009 to June 2020. Demographic, endoscopic and histopathologic data were retrieved from the electronic medical records.

Results A total of 195 patients were included, 56 % women, median age 67 (35-87) years. The median size of GHP was 10 (3-50) mm, 62 % (n = 120) were sessile, 61 % (n = 119) located in the antrum and 36 % (n = 71) had synchronous lesions. Recurrence after endoscopic resection was 23 % (n = 26/113). In multivariate analysis, antrum location was the only risk factor for recurrence (OR 3.0; 95 % CI: 1.1-8.1). The median time to recurrence was estimated at 7.5 (95 % CI 6.7-8.4) years. Overall, 5.1 % (n = 10) GHP showed neoplastic transformation, with low-grade dysplasia in 5, high-grade dysplasia in 4 and adenocarcinoma in 1. In multivariate analysis, size > 25 mm (OR: 84; 95 % CI: 7.4-954), intestinal metaplasia (OR: 7.6; 95 %CI: 1.0-55) and dysplasia (OR: 86; 95 % CI: 10-741) in adjacent mucosa were associated with an increased risk of neoplastic transformation. Recurrence was not associated with neoplastic transformation (OR: 1.1; 95 % CI: 0.2-5.9).

Conclusions Our results confirmed the risk of recurrence and neoplastic transformation of GHP. Antrum location was predictor of recurrence. Lesions > 25mm and intestinal metaplasia and dysplasia in adjacent mucosa were risk factors for neoplastic transformation. A more frequent endoscopic surveillance may be required in these subgroups of GHP.

Citation: João M, Alves S, Areia M et al. eP71 GASTRIC HYPERPLASTIC POLYPS: A BENIGN ENTITY? ANALYSIS OF RECURRENCE AND NEOPLASTIC TRANSFORMATION IN A COHORT STUDY. Endoscopy 2021; 53: S119.

Publication History

Article published online:
19 March 2021