目的:胃增生性息肉(GHP)通常发生在周围粘膜异常,包括自身免疫性化生萎缩性胃炎(AMAG)。我们旨在比较与AMAG相关的GHP患者与非AMAG相关的GHP患者的临床病理特征。
方法:共纳入1170例GHP患者,并对其临床和病理资料进行分析,回顾性。
结果:将GHP患者分为181个A-GHP(A型GHP,AMAG相关GHP)参与者,312B-GHP(B型GHP,幽门螺杆菌感染相关GHP)参与者,根据周围非息肉样粘膜的病理状态,以及677名其他GHP参与者(非A-GHP和非B-GHP)。A-GHP患者年龄较大,主要为女性(p<0.05)。胃镜检查,A-GHP在胃中显示出更少的远端和更多的多区域分布(p<.001)。此外,观察到A-GHP通常很多(55.8%),较大(平均最大直径12.3mm),和更多的花梗或亚花梗(45.3%)(p<.001)。组织病理学,肠上皮化生,上皮内瘤变,GHP内的癌转化占24.3%,9.9%,2.8%的AMAG患者,分别,显著高于B-GHP和其他GHP(p<.05)。然而,周围非息肉样粘膜上皮内瘤变和腺癌差异无统计学意义(p>.05)。
结论:在AMAG患者中出现的GHP是GHP的独特亚组,是重要的癌前病变。来自周围非息肉样粘膜的活检对于评估GHPs的潜在病因至关重要。和内窥镜医师应该注意这些。
OBJECTIVE: Gastric hyperplastic polyp (GHP) commonly arises in the abnormal surrounding mucosa, including autoimmune metaplastic atrophic gastritis (AMAG). We aimed to compare clinicopathological features in patients with GHPs associated with AMAG with those in patients with GHPs associated with non-AMAG.
METHODS: A total of 1170 patients with GHP(s) were enrolled, and their clinical and pathological data were analyzed, retrospectively.
RESULTS: The GHP patients were divided into 181 A-GHP (type A GHP, AMAG-associated GHP) participants, 312 B-GHP (type B GHP, Helicobacter pylori infection-associated GHP) participants, and 677 other GHP participants (non-A-GHP and non-B-GHP) based on pathological status of the surrounding non-polypoid mucosa. The A-GHP patients were older and predominantly female (p < .05). Gastroscopically, A-GHPs showed less distal and more multiple-region distribution in the stomach (p < .001). In addition, the A-GHPs were observed to be usually numerous (55.8%), larger (mean maximum diameter 12.3 mm), and more pedunculated or sub-pedunculated (45.3%) (p < .001). Histopathologically, the intestinal metaplasia, intraepithelial neoplasia, and carcinomatous transformation within GHPs were present in 24.3%, 9.9%, and 2.8% of AMAG patients, respectively, which were significantly higher than those in the B-GHPs and other GHPs (p < .05). However, the differences of intraepithelial neoplasia and adenocarcinoma in surrounding non-polypoid mucosa did not reach statistical significance (p > .05).
CONCLUSIONS: The GHP(s) arising in AMAG patients is a distinct subgroup of GHP(s) and was an important precancerous lesion. The biopsy from surrounding non-polypoid mucosa was essential to evaluate the underlying etiology of the GHPs, and endoscopists should pay attention to these.