Evaluation of gastric hyperplastic polyps and their precursor lesions

Öz

Background and Aims: Approximately 75-90% of gastric polyps are comprised of hyperplastic polyps formed by precursor lesions after foveolar hyperplasia and chronic gastritis due to excessive epithelial regeneration caused by chronic inflammation. In this study, we discuss the relationship between gastric hyperplastic polyps and precursor lesions and Helicobacter pylori as well as intestinal metaplasia and the atrophy states of these lesions in light of the literature. Material and Methods: Among 7,903 patients who underwent esophagogastroduodenoscopy
at Muş State Hospital between January 2016 and January 2020, 172 with an endoscopic view of polypoid structures were included and histopathologically examined. Data including age, sex, admission complaint, location of the polypoid lesion, and histopathological type were recorded. Results: The patients [101 females (58.8%); age, 49.4 ± 15 (19–83) years] underwent polypectomy. They were divided into the reactive polypoid group (57 patients with reactive foveolar hyperplasia and 53 with reactive chronic gastritis) and the actual polypoid group
(62 patients; hyperplastic polyps in 47). Polypoid lesions were most often localized in the antrum. The most common complaint on admission was dyspepsia. The diameter of the actual polypoid lesions was significantly larger than that of the reactive polypoid lesions (p < 0.05). The rate of Helicobacter pylori infection was significantly higher in the reactive polypoid group than in the actual polyploid group (p < 0.05). There was no difference in terms of intestinal metaplasia and atrophy (p > 0.05). Conclusions: No significant differences were observed in the prevalence of intestinal metaplasia and atrophy or between the rates of atrophy and intestinal metaplasia (precancerous condition of the hyperplastic polyps and their precursor lesions). Therefore, biopsy
or excision of endoscopically detected lesions should be performed to diagnose dysplasia. Patients should be treated for Helicobacter pylori.

Anahtar Kelimeler

• Hyperplastic polyp
• foveolar hyperplasia
• chronic gastritis
• Helicobacter pylori

Mide hiperplastik polipleri ve öncül lezyonlarının değerlendirilmesi

Öz

Giriş ve Amaç: Mide poliplerinin yaklaşık %75-90 kadarını hiperplastik polipler oluşturur. Kronik inflamasyon nedenli epitelin aşırı rejenerasyonuna bağlı, foveolar hiperplazi ve kronik gastrit sonrasında bu öncül lezyonlardan hiperplastik polipler oluşur. Bu çalışmada mide hiperplastik polipler ve öncül lezyonlarının Helicobacter pylori ile ilişkisi ve bu lezyonların intestinal metaplazi, atrofi durumlarının literatür bilgileri eşliğinde tartışılması amaçlanmıştır. Gereç ve Yöntem: Muş Devlet Hastanesi Endoskopi ünitesinde Ocak 2016-Ocak 2020 tarihleri arasında özofagogastroduodenoskopi yapılan 7903 hastadan endoskopik görünümü polipoid yapıda olan 172 hastanın histopatolojileri değerlendirildi. Hastaların yaşı, cinsiyeti, başvuru şikâyeti, polipoid görünümlü lezyonun yeri, lezyonların histopatolojik tipi kaydedildi. Bulgular: 172 hastaya polipektomi yapıldı. Hastaların 71’i erkek (%41.2), 101’i kadın (%58.8) olup, yaş ortalamaları 49.4 ± 15 (19-83) yıldı. Hastalar reaktif polipoid lezyonlar; foveolar hiperplazi 57 hasta, kronik gastrit 53 hasta ve gerçek polipoid 62 hasta (en sık hiperplastik polip 47 hasta %75) olarak iki gruba ayrıldı. Polipoid görünümlü lezyonlar en fazla antrumda lokalize idi. Hastaların başvuru şikayeti her iki grupta en fazla dispepsi idi. Gerçek polip lezyonlarının çapı, reaktif polipoid lezyonların çapından istatistiksel olarak büyük saptandı (p < 0.05). Helicobacter pylori oranı reaktif polipoid grupta istatistiksel olarak daha yüksek bulundu (p < 0.05). İntestinal metaplazi ve atrofi durumu açısından fark saptanmadı (p > 0.05). Sonuç: Hiperplastik polipler ve öncül lezyonlarının prekanseröz durumlar olan atrofi ve intestinal metaplazi oranları arasında anlamlı fark saptanmamıştır. Bu yüzden endoskopide saptanan lezyonlardan tanı ve displazinin varlığını saptamak için biyopsi alınmalı ya da eksize edilmeli ve Helicobacter pylori saptanan hastalar tedavi edilmelidir.

Anahtar Kelimeler

• Hiperplastik polip
• foveolar hiperplazi
• kronik gastrit
• Helicobacter pylori

Kaynakça

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