Korean J Fam Pract. 2018; 8(5): 771-774  https://doi.org/10.21215/kjfp.2018.8.5.771
Factors Associated with Neoplastic Transformation in Gastric Polyps
Booyoon Cheung1, Myeong Su Chu2, Ji-Hyun Kim1, Chung Kang1, Seunghee Kim1, Suwha Lee1,*
1Department of Family Medicine, 2Department of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Suwha Lee
Tel: +82-42-220-9523, Fax: +82-42-220-9564
E-mail: drimp@naver.com
ORCID: http://orcid.org/0000-0002-7830-9118
Received: July 27, 2017; Revised: September 19, 2017; Accepted: October 7, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Risk factors for the development of stomach cancer include genetic or familial syndromes, gastric colonization by Helicobacter pylori, and conditions resulting in gastric dysplasia. However, risk factors for malignant transformation of benign gastric ulcers, fundic gland polyps, and the most common type, hyperplastic polyps (HPs), have not been fully revealed. The aim of this study was to identify the incidence of dysplasia and cancer associated with gastric HPs and the factors associated with their neoplastic transformation.
Methods: Between January 2010 and November 2016, data from 683 patients with gastric HPs who underwent endoscopic removal or surgical resection were analyzed retrospectively.
Results: Neoplastic transformation was found in 28 cases (4.1%) of 683 patients with gastric HPs including 4 (0.6%), 5 (0.7%), and 17 (2.5%) cases of low-grade dysplasia, high-grade dysplasia, and adenocarcinoma, respectively. Neoplastic transformations were significantly associated with polyps ＞2 cm in size (n=65 [9.5%] vs. n=618 [90.4%], P=0.049). However, no significant correlation was found between neoplastic transformation and age, sex, number of polyps detected per patient, location of polyps, or H. pylori infection.
Conclusion: Although the incidence of dysplasia and cancer in gastric HPs is still very low, malignant transformation of gastric HPs had a significant correlation with polyps ＞2 cm in size. Therefore, when gastric HPs larger than 2 cm are detected during screening, endoscopic polypectomy or surgical resection should be considered to reduce the risk of neoplastic transformation.
Keywords: Stomach; Cancer; Polyp; Dysplasia; Neoplastic; Transformation
References
  1. Smith RA, Andrews KS, Brooks D, Fedewa SA, Manassaram-Baptiste D, Saslow D, et al. Cancer screening in the United States, 2017: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2017; 67: 100-21.
    Pubmed CrossRef
  2. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin 2003; 53: 5-26.
    Pubmed CrossRef
  3. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea:incidence, mortality, survival and prevalence in 2010. Cancer Res Treat 2013; 45: 1-14.
    Pubmed KoreaMed CrossRef
  4. Choi KS, Kwak MS, Lee HY, Jun JK, Hahm MI, Park EC. Screening for gastric cancer in Korea: population-based preferences for endoscopy versus upper gastrointestinal series. Cancer Epidemiol Biomarkers Prev 2009; 18:1390-8.
    Pubmed CrossRef
  5. Choi IJ. Endoscopic gastric cancer screening and surveillance in high-risk groups. Clin Endosc 2014; 47: 497-503.
    Pubmed KoreaMed CrossRef
  6. Shi J, Qu YP, Hou P. Pathogenetic mechanisms in gastric cancer. World J Gastroenterol 2014; 20: 13804-19.
    Pubmed KoreaMed CrossRef
  7. Dirschmid K, Platz-Baudin C, Stolte M. Why is the hyperplastic polyp a marker for the precancerous condition of the gastric mucosa? Virchows Arch 2006; 448: 80-4.
    Pubmed CrossRef
  8. Morais DJ, Yamanaka A, Zeitune JM, Andreollo NA. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies. Arq Gastroenterol 2007;44: 14-7.
    Pubmed CrossRef
  9. Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995; 90: 2152-9.
    Pubmed
  10. Ahn JY, Son DH, Choi KD, Roh J, Lim H, Choi KS, et al. Neoplasms arising in large gastric hyperplastic polyps: endoscopic and pathologic features. Gastrointest Endosc 2014; 80: 1005-13.e2.
    Pubmed CrossRef
  11. Sung JK. Diagnosis and management of gastric dysplasia. Korean J Intern Med 2016; 31: 201-9.
    Pubmed KoreaMed CrossRef
  12. Zhao G, Xue M, Hu Y, Lai S, Chen S, Wang L. How commonly is the diagnosis of gastric low grade dysplasia upgraded following endoscopic resection? A meta-analysis. PLoS One 2015; 10: e0132699.
    Pubmed KoreaMed CrossRef
  13. Barbosa SHB, Lázaro GC Filho, Franco LM, Valença JT Junior, Nobre E Souza MÂ, Souza MHLP. Agreement between different pathologists in histopathologic diagnosis of 128 gastric polyps. Arq Gastroenterol 2017; 54:263-6.
    Pubmed CrossRef
  14. ASGE Standards of Practice Committee, Evans JA, Chandrasekhara V, Chathadi KV, Decker GA, Early DS, et al. The role of endoscopy in the management of premalignant and malignant conditions of the stomach. Gastrointest Endosc 2015; 82: 1-8.
    Pubmed CrossRef

This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives