Gastric polyps - A clinical study

In 72 of 13,500 patients who underwent endoscopy of the upper digestive tract during an 8-year period, 99 gastric polyps were found. All the polyps were biopsied; 18 were also removed. Histological examination of the 99 polyps showed that 25 were inflammatory, 23 hyperplastic, 17 hyperplasiogenic, 10 adenomatous, 3 hamartomatous, 3 with intestinal metaplasia and 18 with normal mucosa. The histological diagnosis was changed following polypectomy in 50% of the polyps that had been removed. Dysplasia was discovered in two adenomatous polyps; no carcinoma was found. In two cases the polyps were synchronous to carcinoma; in two other cases, they were metachronous to carcinoma. Inflammatory polyps were found in association with inflammation of the upper gastrointestinal tract, such as duodenal and gastric ulcer, esophagitis, gastritis and duodenitis. No correlation was demonstrated between the symptoms and the type or location of the polyps. In 10 patients, who were under observation for an average duration of 3.5 years, 3 polyps disappeared, 1 was removed and 11 had not changed. We conclude that endoscopic polypectomy of gastric polyps may not always be indicated and should be reserved for polyps that were adenomatous, according to the biopsy, or that had grown and changed their shape in a follow-up endoscopy.