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Risk factors associated with recurrence of gastric hyperplastic polyps: a single-center, long-term, retrospective cohort study

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Abstract

Background

The likelihood of recurrence of gastric hyperplastic polyps (GHPs) following endoscopic resection and the need for long-term follow-up remain unknown. We, therefore, aimed to investigate the factors associated with the recurrence and cumulative incidence of GHPs over a 10-year period.

Methods

Between May 1995 and December 2020, 1,018 GHPs > 1 cm were endoscopically resected from 869 patients. Medical records of these patients were retrospectively reviewed and their clinical features and outcomes were assessed. Groups of GHPs with recurrence and those without recurrence group were compared, and univariate and multivariable analyses were performed to identify the potential risk factors for GHP recurrence.

Results

A total of 104 (12.0%) patients who underwent endoscopic removal of GHPs experienced recurrence. Compared to patients without recurrent GHPs, those with recurrent GHPs showed considerably larger median polyp size (28 mm vs. 14 mm, P < 0.001), a higher proportion of multiple polyps (41.3% vs. 29.3%, P = 0.020), polyps with lobulation (63.5% vs. 40.3%, P = 0.001), and exudate (63.5% vs. 46.8%, P = 0.001). Compared to the local recurrence (n = 52) group, the metachronous recurrence (n = 52) group had larger median polyp size (20 mm vs. 16 mm, P = 0.006) as well as higher rates of polyp lobulation (86.5% vs. 40.4%, P < 0.001) and exudate (82.7% vs. 44.4%, P = 0.001). After primary GHP excision, the cumulative incidence of recurrence was 7.2%, 12.7%, and 19.6% at 2 years, 5 years, and 10 years, respectively.

Conclusion

The incidence of GHP recurrence following endoscopic excision increased as the follow-up period increased, especially in patients whose GHPs were large-sized, multiple, or characterized by surface exudates/lobulations.

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References

  1. Carmack SW, Genta RM, Schuler CM, Saboorian MH (2009) The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients. Am J Gastroenterol 104:1524–1532

    Article  PubMed  Google Scholar 

  2. Cao H, Wang B, Zhang Z, Zhang H, Qu R (2012) Distribution trends of gastric polyps: an endoscopy database analysis of 24 121 northern Chinese patients. J Gastroenterol Hepatol 27:1175–1180

    Article  PubMed  Google Scholar 

  3. Wang FW, Young SC, Chen RY, Lin KH, Chen YH, Hsu PI, Yu HC (2018) The prevalence and risk factors of gastric polyp in asymptomatic patients receiving health examination. Gastroenterol Res Pract 2018:9451905

    Article  PubMed  PubMed Central  Google Scholar 

  4. Yacoub H, Bibani N, Sabbah M, Bellil N, Ouakaa A, Trad D, Gargouri D (2022) Gastric polyps: a 10-year analysis of 18,496 upper endoscopies. BMC Gastroenterol 22:70

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jain R, Chetty R (2009) Gastric hyperplastic polyps: a review. Dig Dis Sci 54:1839–1846

    Article  PubMed  Google Scholar 

  6. Kővári B, Kim BH, Lauwers GY (2021) The pathology of gastric and duodenal polyps: current concepts. Histopathology 78:106–124

    Article  PubMed  Google Scholar 

  7. Han AR, Sung CO, Kim KM, Park CK, Min BH, Lee JH, Kim JY, Chang DK, Kim YH, Rhee PL, Rhee JC, Kim JJ (2009) The clinicopathological features of gastric hyperplastic polyps with neoplastic transformations: a suggestion of indication for endoscopic polypectomy. Gut Liver 3:271–275

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kang HM, Oh TH, Seo JY, Joen TJ, Seo DD, Shin WC, Choi WC, Kim JY (2011) Clinical factors predicting for neoplastic transformation of gastric hyperplastic polyps. Korean J Gastroenterol 58:184–189

    Article  PubMed  Google Scholar 

  9. Forté E, Petit B, Walter T, Lépilliez V, Vanbiervliet G, Rostain F, Barsic N, Albeniz E, Gete GG, Gabriel JCM, Cuadrado-Tiemblo C, Ratone JP, Jacques J, Wallenhorst T, Subtil F, Albouys J, Giovannini M, Chaussade S, Landel V, Ponchon T, Saurin JC, Barret M, Pioche M (2020) Risk of neoplastic change in large gastric hyperplastic polyps and recurrence after endoscopic resection. Endoscopy 52:444–453

    Article  PubMed  Google Scholar 

  10. Bar N, Kinaani F, Sperber AD, Amir-Barak H, Dekel R (2021) Low risk of neoplasia and intraprocedural adverse events in gastric hyperplastic polypectomy. J Clin Gastroenterol 55:851–855

    Article  CAS  PubMed  Google Scholar 

  11. Ahn JY, Son DH, Choi KD, Roh J, Lim H, Choi KS, Lee JH, Kim DH, Song HJ, Lee GH, Jung HY, Kim JH, Han S, Park YS (2014) Neoplasms arising in large gastric hyperplastic polyps: endoscopic and pathologic features. Gastrointest Endosc 80:1005-1013.e1002

    Article  PubMed  Google Scholar 

  12. Veereman Wauters G, Ferrell L, Ostroff JW, Heyman MB (1990) Hyperplastic gastric polyps associated with persistent Helicobacter pylori infection and active gastritis. Am J Gastroenterol 85:1395–1397

    CAS  PubMed  Google Scholar 

  13. Abraham SC, Singh VK, Yardley JH, Wu TT (2001) Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol 25:500–507

    Article  CAS  PubMed  Google Scholar 

  14. Horvath B, Pai RK (2016) Prevalence of Helicobacter pylori in gastric hyperplastic polyps. Int J Surg Pathol 24:704–708

    Article  PubMed  Google Scholar 

  15. Nam SY, Park BJ, Ryu KH, Nam JH (2016) Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps. Eur J Gastroenterol Hepatol 28:449–454

    Article  PubMed  Google Scholar 

  16. Islam RS, Patel NC, Lam-Himlin D, Nguyen CC (2013) Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions. Gastroenterol Hepatol (N Y) 9:640–651

    PubMed  Google Scholar 

  17. Yu X, Wang Z, Wang L, Meng X, Zhou C, Xin Y, Sun W, Dong Q (2020) Gastric hyperplastic polyps inversely associated with current Helicobacter pylori infection. Exp Ther Med 19:3143–3149

    PubMed  PubMed Central  Google Scholar 

  18. Kang KH, Hwang SH, Kim D, Kim DH, Kim SY, Hyun JJ, Jung SW, Koo JS, Jung YK, Yim HJ, Lee SW (2018) The effect of Helicobacter pylori infection on recurrence of gastric hyperplastic polyp after endoscopic removal. Korean J Gastroenterol 71:213–218

    Article  PubMed  Google Scholar 

  19. Turkot MH, Januszewicz W, Kaminski MF, Regula J (2020) Su1059 revising the paradigm of endoscopic treatment for gastric hyperplastic polyps: analysis of recurrence rate and malignant progression. Gastroint Endosc 91:AB286

  20. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349

    Article  Google Scholar 

  21. Sharaf RN, Shergill AK, Odze RD, Krinsky ML, Fukami N, Jain R, Appalaneni V, Anderson MA, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Early D, Evans JA, Fanelli RD, Fisher DA, Fisher LR, Foley KQ, Hwang JH, Jue TL, Ikenberry SO, Khan KM, Lightdale J, Malpas PM, Maple JT, Pasha S, Saltzman J, Dominitz JA, Cash BD (2013) Endoscopic mucosal tissue sampling. Gastrointest Endosc 78:216–224

    Article  PubMed  Google Scholar 

  22. Matthew B, David G, Marnix J, Takuji G, Sergio C, di Massimiliano P, Noriya U, Pradeep B, Pritchard DM, Ernst JK, Manuel R-J, Marco RN, Krish R, Neil S, Mario D-R (2019) British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 68:1545

    Article  Google Scholar 

  23. João M, Areia M, Alves S, Elvas L, Taveira F, Brito D, Saraiva S, Teresa Cadime A (2021) Gastric hyperplastic polyps: a benign entity? analysis of recurrence and neoplastic transformation in a cohort study. GE Portug J Gastroenterol 28:328–335

    Article  Google Scholar 

  24. Mikhaĭlusov SV, Bart B, Siluianov SV, Mikhaĭlusova MP, Nikolaeva AS (2010) Duodenogastric reflux and gastric pathology in the elderly patients. Eksp Klin Gastroenterol, 12: 54-59

    Google Scholar 

  25. Park JY, Cornish TC, Lam-Himlin D, Shi C, Montgomery E (2010) Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting. Am J Surg Pathol 34:1591–1598

    Article  PubMed  Google Scholar 

  26. Goddard AF, Badreldin R, Pritchard DM, Walker MM, Warren B (2010) The management of gastric polyps. Gut 59:1270–1276

    Article  PubMed  Google Scholar 

  27. Kume K, Hirakoba M, Murata I, Yoshikawa I, Otsuki M (2001) Disappearance of both MALT lymphoma and hyperplastic polyps in the stomach after eradication of Helicobacter pylori. Am J Gastroenterol 96:2796–2797

    Article  CAS  PubMed  Google Scholar 

  28. Cho Y, Nam S, Moon H, Kim T, Jung J (2023) Helicobacter pylori eradication reduces risk for recurrence of gastric hyperplastic polyp after endoscopic resection. Korean J Intern Med 38:167–175

    Article  PubMed  Google Scholar 

  29. Evans JA, Chandrasekhara V, Chathadi KV, Decker GA, Early DS, Fisher DA, Foley K, Hwang JH, Jue TL, Lightdale JR, Pasha SF, Sharaf R, Shergill AK, Cash BD, DeWitt JM (2015) The role of endoscopy in the management of premalignant and malignant conditions of the stomach. Gastrointest Endosc 82:1–8

    Article  PubMed  Google Scholar 

  30. Taniyama Y, Katanoda K, Charvat H, Hori M, Ohno Y, Sasazuki S, Tsugane S (2017) Estimation of lifetime cumulative incidence and mortality risk of gastric cancer. Jpn J Clin Oncol 47:1097–1102

    Article  PubMed  PubMed Central  Google Scholar 

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Author notes

  1. Yuri Kim and Seokin Kang have contributed equally as the first authors.

Authors and Affiliations

  1. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Gin Hyug Lee, Ho June Song, Kee Don Choi, Do Hoon Kim, Kee Wook Jung, Jeong Hoon Lee & Hee Kyong Na

  2. Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

    Seokin Kang

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Contributions

YK, SK, and JYA contributed to study concept and design; YK, SK, JYA, HYJ, GHL, HJS, KDC, DHK, KWJ, JHL, and HKN contributed to acquisition of data; YK and SK contributed to statistical analysis and interpretation of data; YK and SK contributed to drafting of the manuscript; JYA contributed to critical revision of the manuscript for important intellectual content; JYA contributed to study supervision and final approval of the article.

Corresponding author

Correspondence to Ji Yong Ahn.

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Disclosures

Drs. Yuri Kim, Seokin Kang, Ji Yong Ahn, Hwoon-Yong Jung, Gin Hyug Lee, Ho June Song, Kee Don Choi, Do Hoon Kim, Kee Wook Jung, Jeong Hoon Lee, and Hee Kyong Na disclosed no potential conflicts of interest or financial relationships relevant to this publication.

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Kim, Y., Kang, S., Ahn, J.Y. et al. Risk factors associated with recurrence of gastric hyperplastic polyps: a single-center, long-term, retrospective cohort study. Surg Endosc 37, 7563–7572 (2023). https://doi.org/10.1007/s00464-023-10194-8

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