Published online Sep 7, 2015. doi: 10.3748/wjg.v21.i33.9758
Peer-review started: January 17, 2015
First decision: March 26, 2015
Revised: April 4, 2015
Accepted: April 28, 2015
Article in press: April 28, 2015
Published online: September 7, 2015
AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.
METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy (EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD database. Endoscopic records of 4043 patients diagnosed with gastric polyps were recalled for analysis. Data including demographics, information on polyps such as location, pathological diagnosis, reflux esophagitis and Helicobacter pylori infection were obtained. We focused on epithelial polyps, especially hyperplastic polyps, fundic gland polyps and adenomas, and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists, based on the updated guidelines. To explore the age distribution of gastric polyps over time, we divided patients with polyps into four groups: A (aged < 30 years), B (aged 30-44 years), C (aged 45-59 years) and D (aged > 60 years). Differences in localization, age, and sex distribution of gastric polyps were analyzed by statistical software.
RESULTS: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center, of which 4043 cases were diagnosed with gastric polyps confirmed by pathology. There were 2574 (63%) female and 1469 (37%) male patients with an average age of 54.7 years. The overall prevalence of gastric polyps was 2.6% (4043/157902). Our database demonstrated a rising prevalence of gastric polyps over the decade, increasing from 1.0% (80/8025) to 4.70% (828/17787) between 2004 and 2013. There has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19% (15/80) to 77% (638/828) and hyperplastic polyps decreasing from 65% (52/80) to 15% (123/828). Moreover, data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum, making up 81.3% (1562/1921). Location and age distribution of gastric polyps have also altered. The prevalence of polyps located in the antrum decreased from 37.5% (30/80) to 9.30% (77/828), with an increasing prevalence of polyps in the corpus, from 45% (36/80) to 64.25% (532/828). The constituent ratio of older patients (aged > 60 years) in the polyp population decreased from 62.5% (50/80) to 32.13% (266/828), while that of patients aged 45-60 years showed an increased trend.
CONCLUSION: There was a shift change in the spectrum of gastric polyps in the Chinese population with altered location and age distribution in the past ten years.
Core tip: Recent studies have suggested that fundic gland polyps (FGPs) are the dominant type of gastric polyps rather than hyperplasic polyps. In the Chinese population, data on the spectrum of gastric polyps are limited, and the dynamic change in polyp spectrum has never been evaluated on a large scale. Hence, we retrospectively reviewed 4043 cases with gastric polyps from 157902 patients who underwent esophagogastroduodenoscopy in a tertiary hospital over a 10-year period. We observed a dynamic change in the spectrum of gastric polyps, which presented as a shift in which FGPs rather than hyperplastic polyps were the most common type, and the age, location and sex distribution of gastric polyps were also altered.