GASTRIC POLYPS; THEIR MORPHOLOGICAL AND ENDOSCOPICAL CHARACTERISTICS AND RELATION TO GASTRIC CARCINOMA

Abstract

In 13,200 consecutive gastroscopies, polyp-like lesions were found in 454 patients and of these, 425 were examined histologically. Tumors other than polyps were excluded and there remained 357 cases which were divided in 4 groups: adenoma (8%), hyperplastic polyp (34%), foveolar hyperplasia (21%) and inflammatory polyp (36%). Transitional forms between different groups were seen and sometimes characteristics of different polyp-types could be seen within one and the same polyp. In addition, the mean age of the patients increased in order: inflammatory polyp, foveolar hyperplasia hyperplastic polyp and adenoma, suggesting that the different groups are not separate entities, but represent related stages in the morphogenesis of gastric polyps. Out of 357 patients, 219 cases were reexamined endoscopically on an average of 2.5 yr after the 1st examination. This examination revealed new polyps in 26% of all cases and spontaneous disappearance of the polyps in 14% of cases suggesting that gastric polyps, particularly those of the hyperplastic and inflammatory type are in a dynamically labile state. Gastric carcinoma was found in 27 (8%) of patients with polyps. In 4 of these cases the carcinoma was found at re-examination (which in 3 cases it was performed within 0.5 yr and in 1 case within 1.5 yr). In 14 cases carcinoma was found inside the polyps and in 6 of these the carcinoma was early in its growth. In 13 cases carcinoma was found outside the polyps and in all of these the carcinoma was advanced. Carcinoma was found in 38% of adenoma cases and in 5% of cases with polyps other than adenomas.