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2016 ; 22
(40
): 8883-8891
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Pathophysiological and clinical aspects of gastric hyperplastic polyps
#MMPMID27833379
Markowski AR
; Markowska A
; Guzinska-Ustymowicz K
World J Gastroenterol
2016[Oct]; 22
(40
): 8883-8891
PMID27833379
show ga
Gastric polyps become a major clinical problem because of high prevalence and
tendency to malignant transformation of some of them. The development of gastric
hyperplastic polyps results from excessive proliferation of foveolar cells
accompanied by their increased exfoliation, and they are macroscopically
indistinguishable from other polyps with lower or higher malignant potential.
Panendoscopy allows detection and differentiation of gastric polyps, usually
after obtaining histopathological biopsy specimens. Unremoved gastric
hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential
progression to cancer. For this reason, gastric hyperplastic polyps larger than 5
mm in size should be removed in one piece. After excision of polyps with atypical
focal lesion, endoscopic surveillance is suggested depending on histopathological
diagnosis and possibility of confirming the completeness of endoscopic resection.
Because of the risk of cancer development also in gastric mucosa outside the
polyp, neighboring fragments of gastric mucosa should undergo microscopic
investigations. This procedure allows for identification of patients who can
benefit most from oncological endoscopic surveillance. If Helicobacter pylori (H.
pylori) infection of the gastric mucosa is confirmed, treatment strategies should
include eradication of bacteria, which may prevent progression of intestinal
metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.