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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 10, 2015; 7(10): 995-1002
Published online Aug 10, 2015. doi: 10.4253/wjge.v7.i10.995
Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study
Sherif Elhanafi, Mohammed Saadi, Wynee Lou, Indika Mallawaarachchi, Alok Dwivedi, Marc Zuckerman, Mohamed O Othman
Sherif Elhanafi, Mohammed Saadi, Wynee Lou, Marc Zuckerman, Division of Gastroenterology, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX 77030, United States
Indika Mallawaarachchi, Alok Dwivedi, Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX 77030, United States
Mohamed O Othman, Gastroenterology and Hepatology Section, Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States
Author contributions: Elhanafi S contributed to the study concept and design, acquisition of data, analysis and interpretation of data and drafting of the manuscript; Saadi M and Lou W acquired of data; Mallawaarachchi I and Dwivedi A made the contributed to the analysis and interpretation of data and drafting of the manuscript and statistical analysis; Zuckerman M made the study concept and critical revision of the manuscript for important intellectual content; Othman MO performed the study concept and design critical revision of the manuscript for important intellectual content, statistical analysis and study supervision.
Institutional review board statement: The study was reviewed and approved by Texas Tech University HSC IRB.
Conflict-of-interest statement: All authors disclosed no conflict of interest pertaining to this publication.
Data sharing statement: Dataset available from the corresponding author at Mohamed.othman@bcm.edu. Informed consent for data sharing was not obtained but the presented data are anonymized and risk of identification is low. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mohamed O Othman, MD, Assistant Professor, Gastroenterology and Hepatology Section, Department of Internal Medicine, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, United States. mohamed.othman@bcm.edu
Telephone: +1-713-7980950
Received: March 11, 2015
Peer-review started: March 12, 2015
First decision: March 20, 2015
Revised: April 22, 2015
Accepted: July 7, 2015
Article in press: July 8, 2015
Published online: August 10, 2015
AIM: To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori (H. pylori) status in a predominantly Hispanic population.
METHODS: We conducted a retrospective study of all esophagogastroduodenoscopies performed at our institution. Demographic, endoscopic and histopathological data were reviewed. Categorization of patients into Hispanic and Non-Hispanic was based on self-identification. Patients without resection/biopsy were not included in the analysis. Identification of polyps type was based on histological examination. One way analysis of variance was used to compare continuous variables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp types. Unadjusted and adjusted comparisons of demographic and clinical characteristics were performed according to the H. pylori status and polyp type using logistic regressions.
RESULTS: Of 7090 patients who had upper endoscopy, 335 patients had gastric polyps (4.7%). Resection or biopsy of gastric polyps was performed in 296 patients (88.4%) with a total of 442 polyps removed or biopsied. Of 296 patients, 87 (29%) had hyperplastic polyps, 82 (28%) had fundic gland polyps and 5 (1.7%) had adenomatous polyps. Hyperplastic polyps were significantly associated with positive H. pylori status compared with fundic gland polyps (OR = 4.621; 95%CI: 1.92-11.13, P = 0.001). Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps (OR = 6.903; 95%CI: 1.41-33.93, P = 0.0174). Out of 296 patients, 30 (10.1%) had a follow-up endoscopy with a mean duration of 26 ± 16.3 mo. Interval development of cancer was not noted in any of the patients during follow up period.
CONCLUSION: Gastric hyperplastic polyps were significantly associated with positive H. pylori status and portal hypertensive gastropathy as compared with fundic gland polyps.
Core tip: In a predominantly Hispanic population, the most common gastric polyps were hyperplastic and fundic gland polyps (more than half of gastric polyps). Gastric hyperplastic polyps were significantly associated with positive Helicobacter pylori status and portal hypertensive gastropathy as compared with fundic gland polyps. Hyperplastic polyps and fundic gland polyps were more prevalent in chronic gastritis, while adenomatous polyps were associated with intestinal metaplasia.
